Provider Demographics
NPI:1396180311
Name:INFECTIOUS DISEASES ASSOCIATES
Entity Type:Organization
Organization Name:INFECTIOUS DISEASES ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BHARAT
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOTWANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:563-349-9271
Mailing Address - Street 1:602 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-6145
Mailing Address - Country:US
Mailing Address - Phone:309-736-4189
Mailing Address - Fax:309-736-5031
Practice Address - Street 1:1111 W KIMBERLY RD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-5711
Practice Address - Country:US
Practice Address - Phone:563-468-2011
Practice Address - Fax:563-468-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36006207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty