Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 30928 | IA |
N | 111NI0900X | Internist | 30928 | IA |
Y | 207RR0500X | Rheumatology | 30928 | IA |
NPI | 1053309914 |
---|---|
Provider Name | Scott A Vogelgesang |
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 | 13/10/2005 |
Last Update Date | 17/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0134221 | (05) | IA |
52796 | WELLMARK BCBS (01) | IA |
G18536 | (02) |