Organization
DODGE STREET ANESTHESIOLOGISTS PC
Active
Organization
DODGE STREET ANESTHESIOLOGISTS PC
Active
Other names
DODGE STREET ANESTHESIA PC
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHIR KONERU M.D. (PRESIDENT)
(563) 557-8500
Entity
Organization
Contact information
Practice address
1515 DELHI STREET SUITE 300, DUBUQUE, IA 52001-6320
(563) 557-8500
(563) 589-4078
Mailing address
1515 DELHI STREET SUITE 300, DUBUQUE, IA 52001-6320
(563) 557-8500
(563) 589-4078
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP7443
RAILROAD MEDICARE
IA
Enumeration date
07/04/2006
Last updated
04/19/2013
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