Healthcare Provider Details

I. General information

NPI: 1841233889
Provider Name (Legal Business Name): BRUCE R VANHOUWELING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 W MAIN ST #A
SOLON IA
52333-9764
US

IV. Provider business mailing address

PO BOX 2027
IOWA CITY IA
52244-2027
US

V. Phone/Fax

Practice location:
  • Phone: 319-624-2991
  • Fax: 319-624-3931
Mailing address:
  • Phone: 319-339-3855
  • Fax: 319-358-2737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21861
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: