Provider Demographics
NPI:1326336397
Name:HUNZIKER, BRIAN DAVID (DPM)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DAVID
Last Name:HUNZIKER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 E HICKMAN RD
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-5011
Mailing Address - Country:US
Mailing Address - Phone:515-348-1977
Mailing Address - Fax:515-348-1976
Practice Address - Street 1:80 E HICKMAN RD
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-5011
Practice Address - Country:US
Practice Address - Phone:515-348-1977
Practice Address - Fax:515-348-1976
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA079723213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1326336397Medicaid