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General NPI Number Information
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NPI Number | 1437196045
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY CONSULTANTS PC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 801 HARMONY ST SUITE 201
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-3106
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Country | US
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Telephone | 712-323-1230
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Fax | 712-323-7500
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Provider Business Mailing Address
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Address Line | 801 HARMONY ST SUITE 201
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-3106
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Country | US
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Telephone | 712-323-1230
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Fax | 712-323-7500
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Authorized Official
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Title or Position | OWNER
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Name | VEDHAGIRI SELVAKUMAR
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Credential |
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Telephone | 712-323-1230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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