Individual
DR. VIRGINIA LEE TIDRIRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 IOWA AVE W, MARSHALLTOWN, IA 50158-4768
(641) 754-6700
(641) 753-1375
Mailing address
101 IOWA AVE W, MARSHALLTOWN, IA 50158-4768
(641) 754-6715
(641) 753-1375
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22487
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22487
LICENSE
IA
Enumeration date
09/21/2006
Last updated
02/25/2013
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