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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