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NPI Code Detail

MEDICARE: AMANDA R TEW D.O.

MEDICARE: AMANDA R TEW 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
1207Q00000XFamily Medicine Physician3583IA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1163495OTHERIAFAMILY PRACTICE CLINIC-MEDICARE
2161302OTHERIAWRIGHT MEDICAL CENTER-MEDICARE
516Z302OTHERIAWRIGHT MEDICAL CENTER-MEDICARE SKILLED

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881691608
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA R TEW D.O.
Provider Business Mailing Address
First Line : 215 13TH AVE SW
Second Line :
City : CLARION
State : IA
Zip : 50525-2078
Country : US
Telephone Number : 515-532-2836
Fax Number : 515-532-2523
Provider Business Practice Location Address
First Line : 215 13TH AVE SW
Second Line :
City : CLARION
State : IA
Zip : 50525-2078
Country : US
Telephone Number : 515-532-2836
Fax Number : 515-532-2523
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 12/12/2008

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1417972258 — IOWA SPECIALTY HOSPITAL- CLARION
Practice Location Address:
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Practice Fax: 515-532-2523

Directions to “ AMANDA R TEW D.O.” Practice Location

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