Provider Demographics
NPI:1174563118
Name:BAHLS, DONNA J (MD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:J
Last Name:BAHLS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:12499 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8281
Mailing Address - Country:US
Mailing Address - Phone:515-327-1555
Mailing Address - Fax:515-327-1444
Practice Address - Street 1:12499 UNIVERSITY AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8281
Practice Address - Country:US
Practice Address - Phone:515-327-1555
Practice Address - Fax:515-327-1444
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2013-01-23
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Provider Licenses
StateLicense IDTaxonomies
IA27587208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA3297341Medicaid
A09070Medicare UPIN
IAI15190Medicare ID - Type Unspecified