Provider Demographics
NPI:1932186962
Name:RASMUS, STEPHEN C (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:C
Last Name:RASMUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1351 W CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 3300
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-1889
Mailing Address - Country:US
Mailing Address - Phone:563-383-2667
Mailing Address - Fax:563-383-2672
Practice Address - Street 1:1351 W CENTRAL PARK AVE
Practice Address - Street 2:SUITE 3300
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-1889
Practice Address - Country:US
Practice Address - Phone:563-383-2667
Practice Address - Fax:563-383-2672
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA228932084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A64003OtherJOHN DEERE HEALTHCARE
21900OtherWELLMARK
IA0196907Medicaid
1764535OtherUNITED HEALTHCARE
130005147OtherRAILROAD MEDICARE
130005147OtherRAILROAD MEDICARE
1764535OtherUNITED HEALTHCARE
IAA02509Medicare UPIN