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Organization
DUBUQUE INTERNAL MEDICINE PC
Active
Organization
DUBUQUE INTERNAL MEDICINE PC
Active
Other names
Grand River Medical Group, PC
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN HAFNER (CHIEF EXECUTIVE OFFICER)
(563) 557-9111
Entity
Organization
Contact information
Practice address
1515 DELHI ST, STE 100, DUBUQUE, IA 52001-6389
(563) 557-9111
(563) 589-4063
Mailing address
1515 DELHI ST, STE 100, DUBUQUE, IA 52001-6389
(563) 557-9111
(563) 589-4063
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
NULL
207RH0003X
Hematology & Oncology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
NULL
207RI0011X
Interventional Cardiology Physician
—
—
207RI0200X
Infectious Disease Physician
—
NULL
207RI0200X
Infectious Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
208M00000X
Hospitalist Physician
—
NULL
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
04/20/2006
Last updated
11/06/2019
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