Organization
BOVENMYER DERMATOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ALLEN BOVENMYER M.D. (PRESIDENT)
(563) 359-1671
Entity
Organization
Contact information
Practice address
3319 SPRING ST, SUITE 102, DAVENPORT, IA 52807-2125
(563) 359-1671
(563) 359-7813
Mailing address
3319 SPRING ST, SUITE 102, DAVENPORT, IA 52807-2125
(563) 359-1671
(563) 359-7813
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0132878
—
IA
01
—
0344
WELLMARK BC-BS
IA
01
—
CA9935
MEDICARE ID-TYPE UNSPECIFIED - RAILROAD MEDICARE PTAN
—
Enumeration date
12/03/2006
Last updated
10/01/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us