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General NPI Number Information
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NPI Number | 1841245586
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Entity Type | Organization
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Legal Business Name | CEDAR VALLEY MEDICAL SPECIALISTS PC
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 4006 JOHNATHAN ST
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City | WATERLOO
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State | IA
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Zip | 50701-9395
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Country | US
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Telephone | 319-236-2700
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Fax | 319-236-2714
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Provider Business Mailing Address
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Address Line | PO BOX 2758
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City | WATERLOO
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State | IA
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Zip | 50704-2758
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Country | US
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Telephone | 319-236-2700
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Fax | 319-236-2714
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Authorized Official
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Title or Position | CEO
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Name | VINAY KANTAMNENI
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Credential | MD
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Telephone | 319-235-5390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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