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NPI Code Detail

MEDICARE: DR. MARY LOUISE HLAVIN M.D.

MEDICARE: DR. MARY LOUISE HLAVIN 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
1207T00000XNeurological Surgery Physician32587IA

General Provider Information

NPI Number : 1861486318
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY LOUISE HLAVIN M.D.
Provider Business Mailing Address
First Line : 1026 A AVENUE NE
Second Line : SUITE 5000
City : CEDAR RAPIDS
State : IA
Zip : 52402-5036
Country : US
Telephone Number : 319-369-7085
Fax Number :
Provider Business Practice Location Address
First Line : 1026 A AVENUE NE
Second Line : SUITE 5000
City : CEDAR RAPIDS
State : IA
Zip : 52402-5036
Country : US
Telephone Number : 319-369-7085
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 07/09/2010

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