MEDICARE: DR. ROBERT CARL ZWICKI D.O.

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
1	207Q00000X	Family Medicine Physician	2259	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	37105	OTHER	IA	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437151305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT CARL ZWICKI D.O.

Provider Business Mailing Address
First Line	:	2615 W CENTRAL PARK AVE
Second Line	:
City	:	DAVENPORT
State	:	IA
Zip	:	52804-2504
Country	:	US
Telephone Number	:	563-386-7457
Fax Number	:	563-386-9184

Provider Business Practice Location Address
First Line	:	2615 W CENTRAL PARK AVE
Second Line	:
City	:	DAVENPORT
State	:	IA
Zip	:	52804-2504
Country	:	US
Telephone Number	:	563-386-7457
Fax Number	:	563-386-9184

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	07/08/2007

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