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Individual
DR. INGRID C IWANOW
Active
Individual
DR. INGRID C IWANOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101231531
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689769416
—
VA
01
—
P00417900
RR MEDICARE
VA
Enumeration date
10/04/2006
Last updated
03/05/2021
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