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NPI Code Detail

MEDICARE: DR. JOHN M DONATELLI M.D.

MEDICARE: DR. JOHN M DONATELLI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD036513EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487619789
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN M DONATELLI M.D.
Provider Business Mailing Address
First Line : 9255 ATLANTIC DR SW
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52404-8950
Country : US
Telephone Number : 319-396-2000
Fax Number : 319-396-5567
Provider Business Practice Location Address
First Line : 9255 ATLANTIC DR SW
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52404-8950
Country : US
Telephone Number : 319-396-2000
Fax Number : 319-396-5567
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 03/27/2017

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Directions to “ DR. JOHN M DONATELLI M.D.” Practice Location

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