Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 7039 | SD |
Y | 207Q00000X | Family Doctor | MD-44381 | IA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MD-44381 | IA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | P7453 | TX |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD-44381 | IA |
NPI | 1083811087 |
---|---|
Provider Name | Yuya Hagiwara |
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 | 02/07/2007 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
350614901 | (05) | TX |
350614902 | CSHCN (01) | TX |
5612996 | (05) | SD |
S106499 | MEDICARE (01) | SD |