Individual
ROSELLER LIBARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5409 AVENUE O, FORT MADISON, IA 52627-9601
(319) 376-2134
(319) 376-2188
Mailing address
5409 AVENUE O, FORT MADISON, IA 52627-9601
(319) 376-2134
(319) 376-2188
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35461
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0426536
—
IA
01
—
07604
BLUE CROSS WELLMARK
IA
01
—
504472
IOWA HEALTH SOLUTIONS
IA
01
—
IA0136
JOHN DEERE HEALTH
IA
01
—
P00081383
RAILROAD MEDICARE
IA
Enumeration date
01/26/2006
Last updated
08/01/2007
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