Unknown Individual – Family Medicine Physician, NPI 1689671653
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
2055, Kimball Avenue, Waterloo, Black Hawk County, Iowa, 50702, United States
SUITE 101
WATERLOO, IA 507025047
Phone: (319) 272-2112
Fax: (319) 272-2107
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 50702)
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