Provider Demographics
NPI:1013980739
Name:HUBER, DAVID AUGUSTINE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:AUGUSTINE
Last Name:HUBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 3RD AVE SW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-5716
Mailing Address - Country:US
Mailing Address - Phone:319-298-1234
Mailing Address - Fax:319-298-1235
Practice Address - Street 1:215 3RD AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404
Practice Address - Country:US
Practice Address - Phone:319-298-1234
Practice Address - Fax:319-298-1235
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06432111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1250118Medicaid
IAI11958Medicare ID - Type Unspecified