Individual
TANYA BRUSTER TEGGATZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5264 COUNCIL ST NE, SUITE 100, CEDAR RAPIDS, IA 52402-2471
(319) 221-8444
(319) 221-8589
Mailing address
5100 FOUNTAINS DR. N.E. STE 102, CEDAR RAPIDS, IA 52411
(319) 393-4307
(319) 294-6912
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32590
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4154062
—
IA
Enumeration date
01/18/2007
Last updated
09/02/2016
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