IOWA DERMATOLOGY INSTITUTE, P.C. (NPI# 1265636708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265636708 |
| Entity Type | Organization |
| Organization Name | IOWA DERMATOLOGY INSTITUTE, P.C. |
| Practice Address |
2315 Roosevelt St Clinton IA 52732-2412 |
| Mailing Address |
4909 N Glen Park Place Rd Peoria IL 61614-4676 |
| Practice Telephone | 5632423571 |
| Practice Fax Number | 5632434971 |
| Mailing Telephone | 3096747546 |
| Mailing Fax Number | 3092820500 |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. CARL W. SODERSTROM (PHYSICIAN) |
| Authorized Official Telephone | 3096747546 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| X | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| X | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| X | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians | ||
| X | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians | ||
| X | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
Allopathic & Osteopathic Physicians | ||
| X | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
Allopathic & Osteopathic Physicians |
| Street Address |
2315 ROOSEVELT ST |
| City | CLINTON |
| State | IA |
| Zip Code | 52732-2412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568656999 | Robert G German Md PC | Dermatology | 2315 Roosevelt St, Clinton, IA 52732-2412 | 2007-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891343240 | Janet R Graf | Technician | 450 South 19th St., Clinton, IA 52732 | 2019-08-29 |
| 1346807443 | Karen Daniels | Nurse Practitioner | 2701 Frienship Trl, Apt 1001, Clinton, IA 52732 | 2019-05-23 |
| 1053835256 | Linda Karina Garcia | Physician Assistant | 1410 N Fourth St, Clinton, IA 52732 | 2017-07-29 |
| 1821528423 | Tricia Lee Grimes | Technician | 2349 Dunham St, Clinton, IA 52732 | 2017-06-15 |
| 1750822425 | Danielle Judd | Skilled Nursing Facility | 2220 N 5th St, Clinton, IA 52732 | 2017-03-15 |
| 1689047185 | Connell Family Chiropractic Pllc | Chiropractor | 1485 Main Avenue, Clinton, IA 52732 | 2015-11-05 |
| 1942619713 | Reese Raymond Petersen | Chiropractor | 2319 S 19th St, Clinton, IA 52732 | 2014-08-06 |
| 1487942298 | Wagner Pharmacy Company | Pharmacy | 1726 N. 2nd Street, Clinton, IA 52732 | 2011-07-13 |
| 1275829921 | Rebecca Plante | Pharmacist | 1309 N 2nd Street, Clinton, IA 52732 | 2011-06-21 |
| 1639318363 | Ryan P Connell | Chiropractor | 1437 Main Ave, Clinton, IA 52732 | 2009-02-19 |
| Find all providers in zip 52732 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457728883 | Integrated Dermatology of Clinton,llc | Dermatology | 8 E Main St Ste 101, Clinton, CT 06413-2058 | 2015-09-02 |
| 1356441109 | Surinder K. Arora | Dermatology | 9113 Brandywine Rd, Suite 101, Clinton, MD 20735-2551 | 2006-09-22 |
| 1659390797 | Ellen A Markstein | Dermatology | 8 East Main Street, Suite 101, Clinton, CT 06413-2058 | 2006-07-19 |
| 1548234735 | John Peeler Surratt | Dermatology | 804 Coharie Dr, Clinton, NC 28328-3022 | 2006-02-14 |
| 1841645470 | Magnolia Dermatology, Pllc | Dermatology | 815 Highway 80 E, Clinton, MS 39056-5252 | 2016-05-02 |
| 1225390719 | Patrick Lynn Boler | Dermatology | 815 Highway 80 E, Clinton, MS 39056-5252 | 2012-06-12 |
| 1144404898 | Christin Collier Hurt | Dermatology | 815 Highway 80 E, Clinton, MS 39056-5252 | 2007-12-18 |
| 1568656999 | Robert G German Md PC | Dermatology | 2315 Roosevelt St, Clinton, IA 52732-2412 | 2007-08-29 |
| 1417018375 | David A. Spott, M.d., P.a. | Dermatology | 9131 Piscataway Rd, Suite 550, Clinton, MD 20735-2508 | 2006-12-13 |
| 1467466284 | Sharon Henrietta Barrett | Dermatology | 8 East Main Street, Suite 101, Clinton, CT 06413-2058 | 2006-07-28 |
| Find all providers in CLINTON | ||||
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| 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.