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Bettendorf Pediatric Group

Family Medicine in Bettendorf, IA. Organization (NPI-2).

NPI number1942562467
StatusActive
Last updated in NPPESJun 11, 2012

Details

NPI
1942562467
Entity type
Organization (NPI-2)
Legal business name
Bettendorf Pediatric Group
Organization subpart
No
Enumeration date
Jun 11, 2012
Last updated
Jun 11, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes
208000000X Pediatrics––

Practice location

4017 Devils Glen Rd
Suite 200
Bettendorf, IA 52722-7259

Phone 563-332-3400 · Fax 563-332-4784

Mailing address

4017 Devils Glen Rd
Suite 200
Bettendorf, IA 52722-7259

Phone 563-332-3400 · Fax 563-332-4784

Authorized official

Pomilla Kumar
Owner
5633323400

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