Provider Demographics
NPI:1932239332
Name:HEGDE, SAVITA V (MD)
Entity Type:Individual
Prefix:DR
First Name:SAVITA
Middle Name:V
Last Name:HEGDE
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 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-248-0037
Mailing Address - Fax:319-248-0168
Practice Address - Street 1:2055 OAKDALE RD
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-4704
Practice Address - Country:US
Practice Address - Phone:319-248-0037
Practice Address - Fax:319-248-0168
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-9260207Q00000X
IAMD37508207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID710982297 09OtherI-94# CLASS H1B
ID76632OtherBLUE CROSS OF IDAHO
IDCS10956OtherIDAHO CONTROLLE SUBSTAN #
ID000010162784OtherBLUE SHIELD OF IDAHO GV#
ID807364100Medicaid
ID0-590-941-1OtherECFMG #
ID000010158156OtherBLUESHIELD OF IDAHO GF#
ID000010158157OtherBLUESHIELD OF IDAHO MH#
IDCP8711OtherMEDICARE RAILROAD
IDM-9260OtherIDAHO MEDICAL LICENSE #
IAP01286431OtherRR MEDICARE
IDM-9260OtherIDAHO MEDICAL LICENSE #
IAP01286431OtherRR MEDICARE
IDBH9196242OtherDEA #
ID807364100Medicaid
IDCP8711OtherMEDICARE RAILROAD
IA719260611Medicare PIN
ID1132414Medicare PIN