Organization
NEUROSURGERY CONSULTANTS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID DUANE UDEHN M.D. (PRESIDENT)
(309) 764-3993
Entity
Organization
Contact information
Practice address
4350 7TH ST, UNIT E, MOLINE, IL 61265-6870
(309) 764-3993
(309) 764-4292
Mailing address
4350 7TH ST, UNIT E, MOLINE, IL 61265-6870
(309) 764-3993
(309) 764-4292
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08132080
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/02/2007
Last updated
02/08/2008
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