| Richard Lc Corfman | |
|
2600 Dodge St Ste D4, Unit 25 Dubuque IA 52003-7161 | |
| (563) 513-5908 | |
| (563) 588-3834 |
| Full Name | Richard Lc Corfman |
|---|---|
| Speciality | Social Worker |
| Location | 2600 Dodge St, Dubuque, Iowa |
| Authorized Official Name and Position | Richard Lc Corfman (OWNER OF ENTITY) |
| Authorized Official Contact | 5635135908 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Lc Corfman 2600 Dodge St Ste D4, Unit 25 Dubuque IA 52003-7161 Ph: (563) 513-5908 | Richard Lc Corfman 2600 Dodge St Ste D4, Unit 25 Dubuque IA 52003-7161 Ph: (563) 513-5908 |
| NPI Number | 1699398917 |
|---|---|
| Provider Enumeration Date | 05/20/2020 |
| Last Update Date | 05/20/2020 |
| Certification Date | 05/20/2020 |
| Medicare PECOS PAC ID | 5395169957 |
|---|---|
| Medicare Enrollment ID | O20200716000629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699398917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Richard L C Corfman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619249844 PECOS PAC ID: 2466613260 Enrollment ID: I20120420000457 |
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