BRADLEY T DEWALL (NPI# 1255427597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255427597 |
| Entity Type | Individual |
| Full Name | BRADLEY T DEWALL |
| Credential | MD |
| Practice Address |
21985 277th Ave Le Claire IA 52753 |
| Mailing Address |
2543 Tech Dr Bettendorf IA 52722-3263 |
| Practice Telephone | 5635086330 |
| Mailing Telephone | 6350863305 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2019-06-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 21364 | IA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WELLMARK OF IA | 24004 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1351 W Central Park Ave Ste 1225, Davenport, IA 528041889 | 5634211585 | 5634211595 |
| 3900 28th Avenue Dr Ste 115, Moline, IL 612655536 | 3092812220 |
| Street Address |
21985 277TH AVE |
| City | LE CLAIRE |
| State | IA |
| Zip Code | 52753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376001602 | Zachary Michael Knight | Chiropractor | 1405 Eagle Ridge Road Ste. 2, Leclaire, IA 52753 | 2019-03-05 |
| 1326467036 | Mat Eveleth | Specialist | 2001 Canal Shore Dr. Sw, Leclaire, IA 52753 | 2014-04-09 |
| 1457666232 | Riverview Partners LLC | Dentist | 1111 Canal Shore Dr, Le Claire, IA 52753 | 2010-08-17 |
| 1306025416 | Heather Freyermuth | Occupational Therapist | 902 Iowa Drive, Leclaire, IA 52753 | 2007-10-25 |
| 1821022161 | Gastroenterology Associates PC | Internal Medicine | 2222 53rd Avenue, Bettendorf, IA 52753 | 2006-07-11 |
| 1740311224 | Stephen Walter Byers | Dentist | 126 South Cody Road, Leclaire, IA 52753-0606 | 2007-03-08 |
| 1386067817 | Spring Park Oral and Maxillofacial Surgeons, P.C. | Clinic/Center | 1111 Canal Shore Dr Sw, Le Claire, IA 52753-7602 | 2014-02-04 |
| 1023284023 | Kitzman Chiropractic & Acupuncture Professional Corporation | Chiropractor | 1101 Canal Shore Dr Sw, Le Claire, IA 52753-7602 | 2008-04-30 |
| 1255522025 | Jay Kitzman | Chiropractor | 1101 Canal Shore Dr., Leclaire, IA 52753-7602 | 2007-08-07 |
| 1982970059 | Brett Cortney Nielsen | Chiropractor | 28 Hollows Ct, Le Claire, IA 52753-8001 | 2012-03-22 |
| Find all providers in zip 52753 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346877560 | Mandy Erpelding | Specialist | 3500 Dodge St Ste 105, Dubuque, IA 52003-5208 | 2020-03-26 |
| 1689209793 | Iowa Wellness Center PC | Specialist | 1395 Jordan St Ste C, North Liberty, IA 52317-4759 | 2020-03-09 |
| 1568011203 | Valeria V. Stickler | Specialist | 125 E Washington Street, Suite B, Clarinda, IA 51632 | 2019-09-05 |
| 1518460666 | Tom Taylor | Specialist | 974 Home Plaza, Waterloo, IA 50701 | 2018-03-15 |
| 1306379961 | Ted Schierer | Specialist | 8350 Ep True Parkway, Unit 1201, West Des Moines, IA 50266-8321 | 2017-04-10 |
| 1790147122 | Linda Kaye Renze | Specialist | 2795 100th St, Urbandale, IA 50322-3863 | 2016-03-24 |
| 1578953451 | Sarah Jane Riley | Specialist | 1840 S Gilbert, Iowa City, IA 52240-4340 | 2015-01-29 |
| 1689079931 | April Blong | Specialist | 1809 S Riverside Dr, Ames, IA 50011-3619 | 2014-10-29 |
| 1336558428 | Rebecca Ahrendsen | Specialist | 22301 312th St, Hinton, IA 51024-8859 | 2014-08-04 |
| 1114337748 | Amanda Lowe | Specialist | 3164 230th Street, Rose Hill, IA 52586 | 2014-05-05 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BRADLEY T DEWALL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.