Organization
IC DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA S COLLERAN MD (OWNER)
(319) 339-3872
Entity
Organization
Contact information
Practice address
269 N 1ST AVE, STE 100, IOWA CITY, IA 52245-3616
(319) 339-3872
(319) 339-3874
Mailing address
269 N 1ST AVE, STE 100, IOWA CITY, IA 52245-3616
(319) 339-3872
(319) 339-3874
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
37357
IA
207NS0135X
Procedural Dermatology Physician
37357
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225152374
NPI
IA
Enumeration date
10/17/2012
Last updated
10/17/2012
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