Provider Demographics
NPI:1144226580
Name:NORMAN, DONNA M (DO)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:NORMAN
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:1351 W CENTRAL PARK AVE
Practice Address - Street 2:STE 4100
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-1847
Practice Address - Country:US
Practice Address - Phone:563-383-2581
Practice Address - Fax:563-328-5770
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA01729208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5027060Medicaid
29792OtherWELLMARK BC/BS
034798OtherHEALTH ALLIANCE
19842OtherIOWA HEALTH SOLUTIONS
IA0148OtherJOHN DEERE HEALTH CARE
I3107Medicare PIN
034798OtherHEALTH ALLIANCE