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General NPI Number Information
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NPI Number | 1942516471
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Entity Type | Organization
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Legal Business Name | RED HAW FAMILY MEDICAL CENTER, PC
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Dates
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Enumeration Date | 08/21/2010
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 1030 N 7TH ST
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City | CHARITON
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State | IA
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Zip | 50049-1206
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Country | US
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Telephone | 641-217-9115
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Fax | 641-217-9137
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Provider Business Mailing Address
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Address Line | 1030 N 7TH ST PO BOX 674
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City | CHARITON
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State | IA
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Zip | 50049-1206
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Country | US
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Telephone | 641-217-9115
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Fax | 641-217-9137
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Authorized Official
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Title or Position | FAMILY PRACTICE/OBGYN
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Name | DR. PHILIP DEWAIN SUNDQUIST
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Credential | M.D.
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Telephone | 641-217-9115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 37367
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 37367
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License Number State | IA
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