Provider Demographics
NPI:1811947211
Name:CARR, CYNTHIA (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:RODEWALD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:530 WOODLAND RDG
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-6730
Mailing Address - Country:US
Mailing Address - Phone:563-556-0323
Mailing Address - Fax:
Practice Address - Street 1:200 MERCY DR
Practice Address - Street 2:SUITE 106
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7303
Practice Address - Country:US
Practice Address - Phone:563-589-8899
Practice Address - Fax:563-589-9900
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA32970207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAH41617Medicare UPIN