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General NPI Number Information
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NPI Number | 1770044950
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Entity Type | Individual
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Provider Name | EREZ RONEN NAGGAR DO
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Gender | Male
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 30 E HICKMAN RD
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City | WAUKEE
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State | IA
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Zip | 50263-5011
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Country | US
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Telephone | 515-987-3447
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Fax |
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Provider Business Mailing Address
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Address Line | 30 E HICKMAN RD
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City | WAUKEE
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State | IA
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Zip | 50263-5011
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Country | US
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Telephone | 515-987-3447
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO-05898
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License Number State | IA
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