Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 281087 | NY |
N | 208000000X | Pediatrician | MD-44857 | IA |
Y | 2080P0214X | Pediatric Pulmonologist | MD-44857 | IA |
NPI | 1447506217 |
---|---|
Provider Name | Theodosia Thoma |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2012 |
Last Update Date | 29/08/2018 |