Provider Demographics
NPI:1609255991
Name:FLEEGE, NICOLE MARGO GROGAN (MD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARGO GROGAN
Last Name:FLEEGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:GROGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-7831
Mailing Address - Fax:319-353-8383
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-7831
Practice Address - Fax:319-353-8383
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-45024207R00000X, 207RH0003X, 207RH0003X
IAR-10224207RG0100X, 207RH0002X, 207RH0003X, 207RI0008X, 207RI0200X, 207RN0300X, 207RP1001X, 207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology