Healthcare Provider Details

I. General information

NPI: 1144363540
Provider Name (Legal Business Name): ROBERT CALDWELL DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 06/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 1ST AVE NE
CEDAR RAPIDS IA
52402-5433
US

IV. Provider business mailing address

1700 1ST AVE NE
CEDAR RAPIDS IA
52402-5433
US

V. Phone/Fax

Practice location:
  • Phone: 319-363-3543
  • Fax: 319-366-4567
Mailing address:
  • Phone: 319-363-3543
  • Fax: 319-366-4567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1069270001
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number213ES0103X
License Number StateIA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: DR. PETER E CALDWELL
Title or Position: OWNER
Credential: DPM
Phone: 319-363-3543