Provider Demographics
NPI:1790766608
Name:NEBBE, CARVER WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:CARVER
Middle Name:WILLIAM
Last Name:NEBBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:ISU THIELEN STUDNET HEALTH CTR
Mailing Address - Street 2:2260 THIELEN STUDENT HEALTH CENTER
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50011-0001
Mailing Address - Country:US
Mailing Address - Phone:515-294-5802
Mailing Address - Fax:515-294-7180
Practice Address - Street 1:2260 THIELEN STUDENT HEALTH
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50011-2280
Practice Address - Country:US
Practice Address - Phone:515-294-5802
Practice Address - Fax:515-294-7180
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35329207Q00000X
IAMD-353292084B0040X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA70089OtherBLUE CROSS BLUE SHIELD