Healthcare Provider Details
I. General information
NPI: 1215997739
Provider Name (Legal Business Name): SURGICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2006
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
510 E BLOOMINGTON ST
IOWA CITY IA
52245-2803
US
IV. Provider business mailing address
510 E BLOOMINGTON ST
IOWA CITY IA
52245-2803
US
V. Phone/Fax
- Phone: 319-338-9247
- Fax: 319-338-2785
- Phone: 319-338-9247
- Fax: 319-338-2785
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RICK
A
SHELMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 319-338-9247