SUSAN DALE WALL (NPI# 1962480970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962480970 |
| Entity Type | Individual |
| Full Name | SUSAN DALE WALL |
| Credential | M.D. |
| Practice Address |
269 N 1st Ave Ste 100 Iowa City IA 52245 |
| Practice Telephone | 3193393872 |
| Practice Fax Number | 3193393874 |
| Mailing Telephone | 3193393872 |
| Mailing Fax Number | 3193393874 |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2015-10-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 28400 | IA | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
28400 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0079301 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477627586 | Susan M Wall | Hospitalist | Emory University Hospital Nephrology, 1364 Clifton Rd Ne - 2d Transplant, Atlanta, GA 30322-0001 | 2006-11-20 |
| 1972589018 | Susan Ann Wall | Pharmacist | Usnh Okinawa, Psc 482, Fpo, AP 96362 | 2005-12-20 |
| 1740728088 | Susan Dale Wall | Social Worker | 77 W Forest Ave, Suite 202, Flagstaff, AZ 86001-1479 | 2017-02-07 |
| 1598142366 | Susan Diane Wall | Radiology | 505 Parnassus Ave, San Francisco, CA 94143-2204 | 2015-04-30 |
| 1720476575 | Susan Wall | Nurse Practitioner | 800 Rose St, Lexington, KY 40536-4804 | 2015-01-02 |
| 1245571470 | Susan Wall | Dentist | 1031 Perry Hwy, Pittsburgh, PA 15237-2123 | 2013-03-13 |
| 1508132291 | Susan Wall | Nurse Practitioner | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2012-03-27 |
| 1902105117 | Susan M Wall | Registered Nurse | 2146 Jacksboro Pike, Suite C, La Follette, TN 37766-3024 | 2011-03-28 |
| 1962720052 | Susan K Wall | Occupational Therapy Assistant | 30 Springcrest Ct, Greenville, SC 29607-4034 | 2010-05-13 |
| Street Address |
269 N 1ST AVE STE 100 |
| City | IOWA CITY |
| State | IA |
| Zip Code | 52245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376064154 | Susan Ann Meyer | Nurse Practitioner | 269 N 1st Ave, Iowa City, IA 52245-3616 | 2017-06-30 |
| 1669916102 | Jennifer Cecil Sassman | Nurse Practitioner | 269 N 1st Ave, Iowa City, IA 52245-3616 | 2016-12-16 |
| 1679925069 | Courtney Leigh Henn Engel | Physician Assistant | 269 N 1st Ave, Iowa City, IA 52245-3616 | 2016-07-08 |
| 1477806354 | Ic Dermatology, PC | Dermatology | 269 N 1st Ave, Ste 100, Iowa City, IA 52245-3616 | 2012-10-17 |
| 1467747782 | Dacia N Watts | Registered Nurse | 269 N 1st Ave, Iowa City, IA 52245-3616 | 2011-06-15 |
| 1952549792 | Ic Dermatology PC | Dermatology | 269 N 1st Ave, Suite 100, Iowa City, IA 52245-3616 | 2009-02-02 |
| 1225152374 | Erica Suzanne Colleran | Dermatology | 269 N 1st Ave, Suite 100, Iowa City, IA 52245-3616 | 2007-03-16 |
| 1801933569 | Mercy Services Iowa City, Inc. | Clinic/Center | 269 N 1st Ave, Iowa City, IA 52245-3616 | 2007-01-31 |
| 1013097856 | Dustaff R.c. Persaud | Physician Assistant | 269 N 1st Ave, Iowa City, IA 52245-3616 | 2006-10-16 |
| 1801982475 | Michael H Wallace | Family Medicine | 269 N 1st Ave, Suite 102, Iowa City, IA 52245-3616 | 2006-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730699356 | Mary Beth Shapcott | Registered Nurse | 500 East Market St., Mercy Hospital Diabetes Education, Iowa City, IA 52245 | 2017-10-10 |
| 1366703167 | Elizabeth Bright | Occupational Therapist | 540 E. Jefferson Street., Ste.302, Iowa City, IA 52245 | 2012-06-07 |
| 1043518368 | Robert Brian Goffstein | Ophthalmology | 403 North 7th Ave, Iowa City, IA 52245 | 2011-03-10 |
| 1750682936 | Robert Alvin Blair | Dentist | 134 Broadmoor Lane, Iowa City, IA 52245 | 2010-11-04 |
| 1215167457 | Laura J Ericson | Occupational Therapist | 540 E Jefferson Street, Ste. 302, Iowa City, IA 52245 | 2009-07-22 |
| 1780818294 | Kathryn Leigh Bossen | Physical Therapist | 540 E. Jefferson Street, Ste. 302, Iowa City, IA 52245 | 2009-05-12 |
| 1073751095 | Jessica L Keeran | Physical Therapist | 2751 Northgate Dr. Ne, Iowa City, IA 52245 | 2009-01-29 |
| 1437330370 | Francine Mardarello Hunnicutt | Marriage & Family Therapist | 1610 East College St, Iowa City, IA 52245 | 2007-11-20 |
| 1659574853 | Joan Victoria Rinner | Marriage & Family Therapist | 121 University Services Building, University of Iowa, Iowa City, IA 52245 | 2007-06-06 |
| 1053529966 | Steve Bernt Hammerstrom | Chiropractor | 373 B Scott Court, Iowa City, IA 52245 | 2007-05-21 |
| Find all providers in zip 52245 | ||||
| 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 |
|---|---|---|---|---|
| 1659833622 | Matthew Dacunha | Dermatology | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2019-04-01 |
| 1629537576 | Jordan Brady Evans | Dermatology | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2019-03-19 |
| 1811480254 | Taylor Tabatabai | Dermatology | 200 Hawkins Dr, Iowa City, IA 52242 | 2018-06-11 |
| 1851882716 | Ashley Elizabeth Mcguinness | Dermatology | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2018-05-25 |
| 1467957233 | Sabrina Sisto Alessi Cesar | Dermatology | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2018-03-26 |
| 1649775461 | Alexander Reid | Dermatology | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2018-03-25 |
| 1033647177 | Lainee Goettsche | Dermatology | 200 Hawkins Drive, Department of Dermatology, Iowa City, IA 52242 | 2017-06-02 |
| 1316474976 | Michael Thomas Ginnetti | Dermatology | 200 Hawkins Dr, Iowa City, IA 52242 | 2017-05-15 |
| 1730539404 | Jessica Harms | Dermatology | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2016-06-14 |
| 1104270511 | Patricia Richey | Dermatology | 200 Hawkins Dr, Dept of Internal Medicine, Iowa City, IA 52242-1009 | 2016-04-21 |
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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.