Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 20736 | IA |
N | 2080P0214X | Pediatric Pulmonologist | 20736 | IA |
NPI | 1144216722 |
---|---|
Provider Name | Richard C Ahrens |
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 | 20/09/2005 |
Last Update Date | 27/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0140517 | (05) | IA |
14051 | WELLMARK BCBS (01) | IA |
A01245 | (02) |