Healthcare Provider Details

I. General information

NPI: 1427053842
Provider Name (Legal Business Name): STEVEN J AGUILAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 53RD AVE
BETTENDORF IA
52722-1269
US

IV. Provider business mailing address

4321 53RD AVE
BETTENDORF IA
52722-1269
US

V. Phone/Fax

Practice location:
  • Phone: 563-421-5300
  • Fax: 563-421-5319
Mailing address:
  • Phone: 563-421-5300
  • Fax: 563-421-5319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number30803
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: