Provider Demographics
NPI:1710291505
Name:DAVID H. SEGAL MD EASTERN IOWA BRAIN & SPINE SURGERY PLLC
Entity Type:Organization
Organization Name:DAVID H. SEGAL MD EASTERN IOWA BRAIN & SPINE SURGERY PLLC
Other - Org Name:DAVID H. SEGAL, MD, EASTERN IOWA BRAIN & SPINE SURGERY, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:SURGEON/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HARVEY
Authorized Official - Last Name:SEGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:319-423-7200
Mailing Address - Street 1:600 7TH STREET SE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401-2112
Mailing Address - Country:US
Mailing Address - Phone:319-423-7200
Mailing Address - Fax:319-247-0011
Practice Address - Street 1:600 7TH STREET SE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-2112
Practice Address - Country:US
Practice Address - Phone:319-423-7200
Practice Address - Fax:319-247-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA38342207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1710291505Medicaid
IADQ8568OtherRR MEDICARE
IA1710291505OtherWELLMARK BCBS
IADQ8568OtherRR MEDICARE
IA6734950001Medicare NSC