# DUBUQUE INTERNAL MEDICINE PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grand River Medical Group, PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568427524
- **Authorized official:** JUSTIN HAFNER (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (563) 557-9111

## Contact information

- **Practice address:** 1515 DELHI ST, STE 100, DUBUQUE, IA 52001-6389
- **Practice address phone:** (563) 557-9111
- **Practice address fax:** (563) 589-4063
- **Mailing address:** 1515 DELHI ST, STE 100, DUBUQUE, IA 52001-6389
- **Mailing address phone:** (563) 557-9111
- **Mailing address fax:** (563) 589-4063

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 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