Healthcare Provider Details

I. General information

NPI: 1790766608
Provider Name (Legal Business Name): CARVER WILLIAM NEBBE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 05/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 THIELEN STUDENT HEALTH
AMES IA
50011-2280
US

IV. Provider business mailing address

ISU THIELEN STUDNET HEALTH CTR 2260 THIELEN STUDENT HEALTH CENTER
AMES IA
50011-0001
US

V. Phone/Fax

Practice location:
  • Phone: 515-294-5802
  • Fax: 515-294-7180
Mailing address:
  • Phone: 515-294-5802
  • Fax: 515-294-7180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35329
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberMD-35329
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-35329
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: