Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 128497 | OH |
N | 208000000X | Pediatrician | MD-46199 | IA |
Y | 2080P0208X | Pediatric Infectious Diseases | MD-46199 | IA |
NPI | 1205271954 |
---|---|
Provider Name | Mr. Lukasz Dobromir Weiner |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2013 |
Last Update Date | 29/06/2019 |