Individual
MARILYN J LIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3701 LAFAYETTE RD, EVANSDALE, IA 50707-1129
(319) 274-7060
(319) 233-1156
Mailing address
3701 LAFAYETTE RD, EVANSDALE, IA 50707-1129
(319) 274-7060
(319) 233-1156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24244
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030262
—
IA
01
—
080078033
RR MEDICARE
IA
05
—
1336127737
—
IA
Enumeration date
01/05/2006
Last updated
05/22/2012
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