Provider Demographics
NPI:1871562736
Name:KUSNER, DAVID J (MD PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:KUSNER
Suffix:
Gender:M
Credentials:MD PHD
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:319-688-7440
Mailing Address - Fax:319-887-2971
Practice Address - Street 1:540 E JEFFERSON ST STE 306
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2479
Practice Address - Country:US
Practice Address - Phone:319-688-7440
Practice Address - Fax:319-887-2971
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-29619207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0106575Medicaid
IA14564OtherWELLMARK BCBS
IA0106575Medicaid
F71891Medicare UPIN
IA14564Medicare PIN