Provider Demographics
NPI:1336128354
Name:GIUDICI, MICHAEL C (M D)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:GIUDICI
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 S CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2926
Mailing Address - Country:US
Mailing Address - Phone:641-494-5200
Mailing Address - Fax:641-494-5321
Practice Address - Street 1:250 S CRESCENT DR
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2926
Practice Address - Country:US
Practice Address - Phone:641-494-5200
Practice Address - Fax:641-494-5321
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN70253207RC0001X
IA22577207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
060021827OtherMEDICARE RAILROAD
IA1015933Medicaid
IA27167Medicare PIN
D89649Medicare UPIN
ILL59686Medicare PIN