Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 33308 | IA |
N | 2080P0202X | Pediatric Cardiologist | 9709 | NV |
NPI | 1093700783 |
---|---|
Provider Name | Ian H Law |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2005 |
Last Update Date | 05/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002018487 | (05) | NV |
0206789 | (05) | IA |
15264 | WELLMARK BCBS (01) | IA |
CC8384 | BLUE CROSS BLUE SHIELD (01) | NV |
H10356 | (02) |