Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 34780 | IA |
N | 207ND0101X | MOHS-Micrographic Surgeon | 34780 | IA |
Y | 207NS0135X | Procedural Dermatology | 34780 | IA |
NPI | 1558355859 |
---|---|
Provider Name | Michael J Messingham |
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 | 01/09/2005 |
Last Update Date | 27/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0440156 | (05) | IA |
36453 | WELLMARK BCBS (01) | IA |
I07765 | (02) |