Organization
BASTUG PLASTIC SURGERY PC
Active
Other names
Renaissance Plastic Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DENIZ F BASTUG MD (PRESIDENT)
(319) 272-8550
Entity
Organization
Contact information
Practice address
2710 SAINT FRANCIS DR, SUITE 419, WATERLOO, IA 50702-5619
(319) 272-8550
(319) 272-8558
Mailing address
2710 SAINT FRANCIS DR, SUITE 419, WATERLOO, IA 50702-5634
(319) 272-8550
(319) 272-8558
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
32236
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1162420
—
IA
01
—
249985
MIDLAND'S CHOICE
IA
01
—
32236
MEDICAL LICENSE
IA
01
—
41756
WELLMARK
IA
01
—
IA0101
JOHN DEERE HEALTH CARE
IA
Enumeration date
08/08/2006
Last updated
10/14/2011
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