Organization
DUBUQUE INTERNAL MEDICINE PC
Active
Other names
Grand River Medical Group, PC
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN HAFNER (CHIEF EXECUTIVE OFFICER)
(563) 557-9111
Entity
Organization
Contact information
Practice address
1515 DELHI ST, STE 100, DUBUQUE, IA 52001-6389
(563) 557-9111
(563) 589-4063
Mailing address
1515 DELHI ST, STE 100, DUBUQUE, IA 52001-6389
(563) 557-9111
(563) 589-4063
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
04/20/2006
Last updated
11/06/2019
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