Provider Demographics
NPI:1023528429
Name:CEDAR VALLEY MEDICAL SPECIALISTS, PC
Entity type:Organization
Organization Name:CEDAR VALLEY MEDICAL SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VINAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KANTAMNENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:319-235-5390
Mailing Address - Street 1:PO BOX 2758
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50704-2758
Mailing Address - Country:US
Mailing Address - Phone:319-235-5390
Mailing Address - Fax:319-235-5607
Practice Address - Street 1:909 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:IA
Practice Address - Zip Code:50674-1203
Practice Address - Country:US
Practice Address - Phone:319-833-5922
Practice Address - Fax:319-833-5923
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CEDAR VALLEY MEDICAL SPECIALISTS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-11
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies