Provider Demographics
NPI:1124043955
Name:NEUERBURG, RONALD C (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:C
Last Name:NEUERBURG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1376 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ELDORA
Mailing Address - State:IA
Mailing Address - Zip Code:50627-1631
Mailing Address - Country:US
Mailing Address - Phone:641-939-3831
Mailing Address - Fax:641-939-3922
Practice Address - Street 1:1376 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ELDORA
Practice Address - State:IA
Practice Address - Zip Code:50627-1631
Practice Address - Country:US
Practice Address - Phone:641-939-3831
Practice Address - Fax:641-939-3922
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04781111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA18517OtherBLUE CROSS/BLUE SHIELD
IA0185173Medicaid
46880OtherBC/BS GRP #
I6486OtherMEDICARE GRP #
0267732OtherMEDICAID GRP #
I6486OtherMEDICARE GRP #
0267732OtherMEDICAID GRP #