Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 26670 | IA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 26670 | IA |
NPI | 1245218023 |
---|---|
Provider Name | Paul B Volker |
First Address | Des Moines, IA 50312-4104 |
Second Address | Des Moines, IA 50312-4104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 09/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080090474 | RR MEDICARE (01) | IA |
1245218023 | (05) | IA |
2049221 | (05) | IA |
A03715 | (02) |