Nystrom, David

Nystrom, David is an individual health care provider with primary practice located at 405 S Clark St Suite # 230, Carroll IA 51401-3065. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Nystrom, David can be contacted via phone (712) 792-2222.

Contact Information

Primary practice address
405 S Clark St Suite # 230 Carroll IA 51401-3065
Fax: (712) 792-3875
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3647 Iowa

Profile Details

NPI number 1356315311
LBN Legal business name Nystrom, David
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Oct 9th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356315311 NPPES
Iowa MEDICAID 0469395

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