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Individual

RICHARD M KISHIUE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
865 LINCOLN RD, STE 100, BETTENDORF, IA 52722-4159
(563) 355-1000
(563) 344-2975
Mailing address
865 LINCOLN RD, STE L10, BETTENDORF, IA 52722-4159
(563) 355-9191
(563) 355-3419

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
23445
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019811
IOWA HEALTH SOLUTIONS
01
035512
HEALTH ALLIANCE
01
29599
WELLMARK BC/BS
05
4212043
IA
01
4796890005
DMERC
01
IA0141
JOHN DEERE HEALTH PLAN
Enumeration date
06/21/2005
Last updated
07/09/2007
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