Organization
EPIPHANY DERMATOLOGY OF IOWA, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHEORGHE PUSTA (EXECUTIVE DIRECTOR)
(512) 628-0465
Entity
Organization
Contact information
Practice address
5264 COUNCIL ST NE STE 700, CEDAR RAPIDS, IA 52402-2477
(319) 363-9963
(319) 363-0520
Mailing address
7300 RANCH RD. 2222, BLDG 1, STE 200, AUSTIN, TX 78730-3255
(512) 628-0465
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
03/04/2020
Last updated
12/07/2023
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