Individual
PRATIBHA DUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1717 W RIDGEWAY AVE, WATERLOO, IA 50701-4543
(319) 833-5700
(319) 833-5740
Mailing address
1717 W RIDGEWAY AVE, WATERLOO, IA 50701-4543
(319) 833-5700
(319) 833-5740
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35236
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0422949
—
IA
05
—
1235116369
—
IA
01
—
P00066566
RR MEDICARE
IA
Enumeration date
12/29/2005
Last updated
05/22/2012
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