Healthcare Provider Details

I. General information

NPI: 1245625151
Provider Name (Legal Business Name): JOHN DANIEL HERLIHY IV M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 10TH ST SE
CEDAR RAPIDS IA
52403-1292
US

IV. Provider business mailing address

701 10TH ST SE
CEDAR RAPIDS IA
52403-1251
US

V. Phone/Fax

Practice location:
  • Phone: 319-369-4542
  • Fax: 319-369-4543
Mailing address:
  • Phone: 319-369-4542
  • Fax: 319-369-4543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD-53981
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: