Provider Demographics
NPI:1497743686
Name:SCHLUETER, ANNETTE J (MD)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:J
Last Name:SCHLUETER
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 1:200 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:319-356-0370
Mailing Address - Fax:319-356-0331
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:319-356-0370
Practice Address - Fax:319-356-0331
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA31212207ZB0001X, 207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA33952OtherWELLMARK BCBS
IA45354OtherWELLMARK BCBS
IA0179580Medicaid
IA1179580Medicaid
IA1179580Medicaid
IAP00050292Medicare PIN
IAI9695Medicare PIN
IA0179580Medicaid