Provider Demographics
NPI:1588628101
Name:SHRECK, ROBERT R (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:SHRECK
Suffix:
Gender:
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:515-282-2921
Mailing Address - Fax:515-282-1035
Practice Address - Street 1:1221 PLEASANT ST STE 100
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1424
Practice Address - Country:US
Practice Address - Phone:515-282-2921
Practice Address - Fax:515-282-1035
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-19828207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0160143Medicaid
IA0160143Medicaid
IAA01446Medicare UPIN
IA58988Medicare ID - Type Unspecified