Provider Demographics
NPI:1336137132
Name:DEE, FRED R (MD)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:R
Last Name:DEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-384-4436
Mailing Address - Fax:319-384-4437
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-384-4436
Practice Address - Fax:319-384-4437
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17796207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0224352Medicaid
IA22435OtherWELLMARK BCBS
IA33931OtherWELLMARK BCBS
IA1224352Medicaid
IA22435Medicare PIN
IA1224352Medicaid
IA0224352Medicaid
A02613Medicare UPIN