Ic Dermatology PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

28400 Issued in IA

Legal business name

IC DERMATOLOGY PC

Practice address

269 N 1St Ave
Suite 100
Iowa City, IA 52245-3616

Phone

(319) 339-3972

Fax

(319) 339-3974

NPI assigned

Feb 2, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Erica Colleran, MD

Title

Medical Doctor

Phone

(319) 338-3972

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Dale Wall, M.D.

  • Dermatology Physician
  • Iowa City, IA
  • NPI 1962480970
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1952549792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 N 1ST AVE",
            "address_2": "SUITE 100",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522453616",
            "telephone_number": "319-339-3972",
            "fax_number": "319-339-3974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 N 1ST AVE",
            "address_2": "SUITE 100",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522453616",
            "telephone_number": "319-339-3972",
            "fax_number": "319-339-3974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IC DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-02",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "COLLERAN",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "319-338-3972",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "IA",
            "license": "28400",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "IA",
            "license": "28400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pollyanne Iben, DDS
• Hisham Abdellah Osman Ibrahim, MD
• Khansaa Ibrahim, RBT
• Steven Ibrahim
• Merete Ibsen, MD
• Ic Dermatology, PC
• Ic Strength Physical Therapy PLLC
• Michael S Icardi, MD
• Olusola A Idowu, MBBS
• Amar Musa Idris, HOMECARE AGENCY

• Dermatology Physician in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Dermatology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.