Individual
SHIRA TANNENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1227 E RUSHOLME ST, DAVENPORT, IA 52803-2459
(563) 324-8160
(563) 324-8486
Mailing address
PO BOX 1245, BETTENDORF, IA 52722-0021
(563) 324-8160
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DO-04709
IA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
DO-04709
IA
Other
Enumeration date
05/13/2010
Last updated
07/22/2024
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