Provider Demographics
NPI:1730175803
Name:SAVAGE, ALFRED DAVID (DO)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:DAVID
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:107 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-2071
Mailing Address - Country:US
Mailing Address - Phone:319-385-4915
Mailing Address - Fax:319-385-2118
Practice Address - Street 1:107 E MADISON ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-2071
Practice Address - Country:US
Practice Address - Phone:319-385-4915
Practice Address - Fax:319-385-2118
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA01491207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0133710Medicaid
IAA004610OtherCHAMPUS
IA791113496OtherRAILROAD MEDICARE
IA$$$$$$$$$OtherPRIVATE PAYOR INSURANCE
IA0133710Medicaid
IA791113496OtherRAILROAD MEDICARE