Healthcare Provider Details

I. General information

NPI: 1952565368
Provider Name (Legal Business Name): DMITRIY M ACHERKAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 OAKDALE RD
CORALVILLE IA
52241-4704
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-668-2722
  • Fax: 319-688-2491
Mailing address:
  • Phone: 319-668-2722
  • Fax: 319-688-2491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD-39445
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-39445
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: