Provider Demographics
NPI:1861415994
Name:UNGER, MICHAEL S (PAC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:UNGER
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5885 SUNNYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4203
Mailing Address - Country:US
Mailing Address - Phone:712-266-2700
Mailing Address - Fax:712-266-2719
Practice Address - Street 1:5885 SUNNYBROOK DR
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4203
Practice Address - Country:US
Practice Address - Phone:712-266-2700
Practice Address - Fax:712-266-2719
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01131363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
219640028Medicare PIN
IAS57370Medicare UPIN
IA11352OtherWELLMARK
IA970026886Medicare ID - Type UnspecifiedRAILROAD