Provider Demographics
NPI:1396734521
Name:HARSWICK, CHAD A (MD)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:A
Last Name:HARSWICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 510TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-9418
Mailing Address - Country:US
Mailing Address - Phone:515-708-4219
Mailing Address - Fax:
Practice Address - Street 1:6400 510TH AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-9418
Practice Address - Country:US
Practice Address - Phone:515-708-4219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36054207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0459792Medicaid
IA0459792Medicaid
IAI15033Medicare UPIN