Individual
DR. MICHAEL J NIEHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1223 S GEAR AVE, STE 202, WEST BURLINGTON, IA 52655-1685
(319) 768-4350
(319) 768-4355
Mailing address
PO BOX 540, WEST BURLINGTON, IA 52655-1685
(319) 768-4350
(319) 768-4355
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
21014
IA
208600000X
Surgery Physician
Primary
23646
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0085811
—
IA
01
—
020013500
RRMC
—
05
—
1023564
—
IA
05
—
19927674096
—
IA
01
—
70237
BLUE SHIELD
IA
01
—
C01404
RR MED
IA
01
—
P00424584
RR MED
IA
Enumeration date
03/20/2006
Last updated
03/07/2023
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