Provider Demographics
NPI:1013989441
Name:SAETRE, SIV BRIT (MD)
Entity Type:Individual
Prefix:
First Name:SIV
Middle Name:BRIT
Last Name:SAETRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 E RUSHOLME ST
Mailing Address - Street 2:STE 203
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-2400
Mailing Address - Country:US
Mailing Address - Phone:563-322-0923
Mailing Address - Fax:563-322-7403
Practice Address - Street 1:1230 E RUSHOLME ST
Practice Address - Street 2:STE 203
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-2400
Practice Address - Country:US
Practice Address - Phone:563-322-0923
Practice Address - Fax:563-322-7403
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA29529207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0105650Medicaid
020428OtherHEALTH ALLIANCE
IA13062OtherWELLMARK BCBS
15622OtherMIDLANDS CHOICE
1764565OtherUNITED HEALTHCARE
IA13062OtherWELLMARK BCBS
020428OtherHEALTH ALLIANCE
F33212Medicare UPIN
71964Medicare ID - Type Unspecified
IA0105650Medicaid
IA71964Medicare PIN