1932239332 NPI number — DR. SAVITA V HEGDE MD

Table of content: DR. SAVITA V HEGDE MD (NPI 1932239332)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932239332 NPI number — DR. SAVITA V HEGDE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HEGDE
Provider First Name:
SAVITA
Provider Middle Name:
V
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932239332
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 HAWKINS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IOWA CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52242-1009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-248-0037
Provider Business Mailing Address Fax Number:
319-248-0168

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2055 OAKDALE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORALVILLE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52241-4704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-248-0037
Provider Business Practice Location Address Fax Number:
319-248-0168
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  M-9260 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: MD37508 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 710982297 09 . This is a "I-94# CLASS H1B" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 76632 . This is a "BLUE CROSS OF IDAHO" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: CS10956 . This is a "IDAHO CONTROLLE SUBSTAN #" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 000010162784 . This is a "BLUE SHIELD OF IDAHO GV#" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 807364100 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0-590-941-1 . This is a "ECFMG #" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 000010158156 . This is a "BLUESHIELD OF IDAHO GF#" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 000010158157 . This is a "BLUESHIELD OF IDAHO MH#" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: CP8711 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: M-9260 . This is a "IDAHO MEDICAL LICENSE #" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: P01286431 . This is a "RR MEDICARE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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