Provider Demographics
NPI:1487626990
Name:HOGANSON, DEANA DAWN (MD)
Entity Type:Individual
Prefix:
First Name:DEANA
Middle Name:DAWN
Last Name:HOGANSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8421 PLUM DR
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-7356
Mailing Address - Country:US
Mailing Address - Phone:515-270-7222
Mailing Address - Fax:515-270-7202
Practice Address - Street 1:8421 PLUM DR
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7356
Practice Address - Country:US
Practice Address - Phone:515-643-9699
Practice Address - Fax:515-643-9698
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN47671207RR0500X, 207R00000X
IA39569207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN829133100Medicaid
WI35226000Medicaid
IAENROLLEDMedicaid
I42578Medicare UPIN
MN110010392Medicare PIN