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Individual
TIMOTHY STAUDTE
Active
Individual
TIMOTHY STAUDTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
3565
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0431908
—
IA
01
—
19873
BLUE CROSS BLUE SHIELD
IA
01
—
507288
IOWA HEALTH SOLUTIONS
IA
01
—
IA0139
JOHN DEERE HEALTH
IA
01
—
P00157242
RAILROAD MEDICARE
IA
Enumeration date
02/07/2006
Last updated
08/01/2007
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