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NPI Code Detail

MEDICARE: DR. CHARLES D CIBULA D.P.M

MEDICARE:  DR. CHARLES D CIBULA  D.P.M
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
1213ES0103XFoot & Ankle Surgery PodiatristBM25495090685MI
2213ES0103XFoot & Ankle Surgery Podiatrist000836IA

General Provider Information

NPI Number : 1750590246
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES D CIBULA D.P.M
Provider Business Mailing Address
First Line : 4508 CHADWICK RD
Second Line : CEDAR VALLEY PODIATRY PC
City : CEDAR FALLS
State : IA
Zip : 50613-7958
Country : US
Telephone Number : 319-277-4508
Fax Number : 319-277-8908
Provider Business Practice Location Address
First Line : 4508 CHADWICK RD
Second Line : CEDAR VALLEY PODIATRY PC
City : CEDAR FALLS
State : IA
Zip : 50613-7958
Country : US
Telephone Number : 319-277-4508
Fax Number : 319-277-8908
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 07/29/2010

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