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General NPI Number Information
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NPI Number | 1316231012
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Entity Type | Organization
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Legal Business Name | RADIATION ONCOLOGY OF IOWA, PC
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Dates
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Enumeration Date | 05/31/2011
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Last Update Date | 08/01/2017
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Provider Practice Location Address
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Address Line | 350 NORTH GRANDVIEW AVENUE
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City | DUBUQUE
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State | IA
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Zip | 52001
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Country | US
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Telephone | 563-589-2468
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Fax | 563-589-2368
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Provider Business Mailing Address
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Address Line | PO BOX 1086
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City | DUBUQUE
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State | IA
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Zip | 52004-1086
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Country | US
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Telephone | 563-556-3175
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Fax | 563-594-5256
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Authorized Official
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Title or Position | PHYSICIAN
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Name | NAGENDRA KONERU
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Credential | MD
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Telephone | 312-859-2564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State | IA
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