Active NPI
Susan C Puhl, M.D.
- Dermatology Physician
- Coralville, IA
National Provider Identifier
1649403296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 18327
- Practice address
- 501 12TH Ave
Suite 101
Coralville, IA 52241-1774 - Phone
- (319) 337-3177
- Fax
- (319) 341-0024
- NPI assigned
- Aug 31, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 18327 | IA | Primary |
Addresses
Primary practice location
501 12TH Ave
Suite 101
Coralville, IA 52241-1774
Mailing address
501 12TH Ave
Suite 101
Coralville, IA 52241
Phone (319) 337-3177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18327 | IA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251676800000",
"number": "1649403296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 12TH AVE",
"address_2": "SUITE 101",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "52241",
"telephone_number": "319-337-3177",
"fax_number": "319-341-0024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 12TH AVE",
"address_2": "SUITE 101",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522411774",
"telephone_number": "319-337-3177",
"fax_number": "319-341-0024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUHL",
"first_name": "SUSAN",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-31",
"last_updated": "2009-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IA",
"license": "18327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coralville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.