Provider Demographics
NPI:1326095704
Name:TRUHLAR, SCOTT MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MICHAEL
Last Name:TRUHLAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2771 OAKDALE BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-9747
Mailing Address - Country:US
Mailing Address - Phone:319-545-7310
Mailing Address - Fax:319-626-7314
Practice Address - Street 1:2769 HEARTLAND DRIVE
Practice Address - Street 2:SUITE 105
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241
Practice Address - Country:US
Practice Address - Phone:319-545-7300
Practice Address - Fax:319-545-7314
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA342762085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA22809OtherBLUE CROSS BLUE SHIELD
IA22833OtherBLUE CROSS BLUE SHIELD
IA2295139Medicaid
IA1295139Medicaid
IA19366OtherBLUE CROSS BLUE SHIELD
IA1295139Medicaid