Individual
DR. CALEB PANIAMOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-5000
Mailing address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
3665
IA
207P00000X
Emergency Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0577783
—
IA
05
—
1577783
—
IA
05
—
2577783
—
IA
01
—
503523
IHS
—
01
—
99286
BCWELLMARK 7TH
—
01
—
99291
BCWELLMARK WEST
—
01
—
IL0181
JOHN DEERE ILLINOIS
—
Enumeration date
03/22/2006
Last updated
10/20/2007
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