Provider Demographics
NPI:1386902781
Name:GLOBAL INFECTIOUS DISEASE SERVICES, PC
Entity type:Organization
Organization Name:GLOBAL INFECTIOUS DISEASE SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERTHA
Authorized Official - Middle Name:S
Authorized Official - Last Name:AYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:712-226-4437
Mailing Address - Street 1:741 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51108-9514
Mailing Address - Country:US
Mailing Address - Phone:712-255-7077
Mailing Address - Fax:
Practice Address - Street 1:2918 HAMILTON BLVD
Practice Address - Street 2:UPPER D SUITE 103
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-2414
Practice Address - Country:US
Practice Address - Phone:712-226-4437
Practice Address - Fax:712-522-2846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty