Provider Demographics
NPI:1104069137
Name:CUNDIFF, CLAIRE IDA A (MD)
Entity type:Individual
Prefix:DR
First Name:CLAIRE IDA
Middle Name:A
Last Name:CUNDIFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 A AVENUE NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402
Mailing Address - Country:US
Mailing Address - Phone:319-391-5501
Mailing Address - Fax:319-743-2610
Practice Address - Street 1:855 A AVENUE NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402
Practice Address - Country:US
Practice Address - Phone:319-391-5501
Practice Address - Fax:319-743-2610
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA43936207V00000X
HIMD-14677208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN