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Individual

LAWRENCE G HUNSICKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20419
IA
207RN0300X
Nephrology Physician
Primary
20419
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0132837
IA
01
13283
WELLMARK BCBS
IA
Enumeration date
11/14/2005
Last updated
07/23/2009
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