Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | DO-02934 | IA |
N | 2080P0201X | Pediatric Allergist | DO-02934 | IA |
Y | 2080P0214X | Pediatric Pulmonologist | 02934 | IA |
NPI | 1982699260 |
---|---|
Provider Name | Scott J Sheets |
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 | 13/09/2005 |
Last Update Date | 29/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0297234 | (05) | IA |
H98664 | (02) | |
IB1654001 | MEDICARE PTAN (01) | IA |