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NPI Code Detail

MEDICARE: RIAD M. RAHHAL M.D.

MEDICARE: RIAD M. RAHHAL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080P0206XPediatric Gastroenterology PhysicianR-7397IA
22080P0206XPediatric Gastroenterology Physician37164IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
170401OTHERIAWELLMARK BCBS

General Provider Information

NPI Number : 1073722112
Entity Type Code : Individual
Provider Name (Legal Business Name) : RIAD M. RAHHAL M.D.
Provider Business Mailing Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1009
Country : US
Telephone Number : 319-356-1616
Fax Number : 319-384-6004
Provider Business Practice Location Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1009
Country : US
Telephone Number : 319-356-1616
Fax Number : 319-384-6004
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 02/09/2010

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