Individual
MICHAEL S ICARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-8632
(319) 384-8053
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-8632
(319) 384-8053
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
34286
IA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
91388
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0249870
—
IA
05
—
1249870
—
IA
01
—
33936
WELLMARK BCBS
IA
01
—
42715
WELLMARK BCBS
IA
Enumeration date
10/06/2005
Last updated
04/11/2022
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