Provider Demographics
NPI:1679538086
Name:GIUDICI, PAULA A (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:A
Last Name:GIUDICI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:PAULA
Other - Middle Name:M
Other - Last Name:ANNECHINO
Other - Suffix:
Other - Last Name Type:Former Name
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:319-384-6012
Mailing Address - Fax:319-353-6284
Practice Address - Street 1:105 E 9TH ST
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2209
Practice Address - Country:US
Practice Address - Phone:319-467-2000
Practice Address - Fax:319-467-2410
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA26831207N00000X
IL036077938207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI5200Medicare PIN
E30598Medicare UPIN