Individual
LISA M ANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-6437
(319) 384-8220
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-6437
(319) 384-8220
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
33804
IA
207RN0300X
Nephrology Physician
Primary
33804
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0223883
—
IA
01
—
24789
WELLMARK BCBS
IA
Enumeration date
10/13/2005
Last updated
11/28/2007
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