Healthcare Provider Details

I. General information

NPI: 1679538086
Provider Name (Legal Business Name): PAULA A. GIUDICI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS PAULA M. ANNECHINO

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 11/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E 9TH ST
CORALVILLE IA
52241-2209
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-467-2000
  • Fax: 319-467-2410
Mailing address:
  • Phone: 319-384-6012
  • Fax: 319-353-6284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number26831
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number036077938
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: