| Diagnostic & Int Med Assoc Pc | |
|
201 Ridge St Suite 302 Council Bluffs IA 51503-4643 | |
| (712) 322-5532 | |
| (800) 293-4214 |
| Full Name | Diagnostic & Int Med Assoc Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 201 Ridge St, Council Bluffs, Iowa |
| Authorized Official Name and Position | Barry L Kricsfeld (PRESIDENT OWNER) |
| Authorized Official Contact | 7123225532 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diagnostic & Int Med Assoc Pc 201 Ridge St Suite 302 Council Bluffs IA 51503-4643 Ph: (712) 322-5532 | Diagnostic & Int Med Assoc Pc 201 Ridge St Suite 302 Council Bluffs IA 51503-4643 Ph: (712) 322-5532 |
| NPI Number | 1104870690 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 11/14/2013 |
| Medicare PECOS PAC ID | 2264327014 |
|---|---|
| Medicare Enrollment ID | O20040219000570 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104870690 | NPI | - | NPPES |
| 0129437 | Medicaid | IA | |
| CP8208 | Other | IA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Alan S Kricsfeld |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467406017 PECOS PAC ID: 1052209269 Enrollment ID: I20040309000814 |
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