Provider Demographics
NPI:1255319422
Name:STAUB, DAVID B (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:STAUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3740 UTICA RIDGE RD STE A
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-1624
Mailing Address - Country:US
Mailing Address - Phone:563-359-4440
Mailing Address - Fax:563-359-4644
Practice Address - Street 1:3740 UTICA RIDGE RD STE A
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1624
Practice Address - Country:US
Practice Address - Phone:563-359-4440
Practice Address - Fax:563-359-4644
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA27098207RR0500X
IL036079818207RR0500X
IAMD-27098207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA57866OtherWELLMARK
043120OtherHEALTH ALLIANCE
IA0500347Medicaid
19854OtherIA HEALTH SOLUTIONS
IAT81130OtherJOHN DEERE FAMILY
IL8121085OtherBCBS
13498OtherMIDLANDS CHOICE
200029102OtherRR MEDICARE
043120OtherHEALTH ALLIANCE
IA57866OtherWELLMARK
E07365Medicare UPIN
ILK26921Medicare ID - Type Unspecified