DR. LYDIA MUSTAFIC (NPI# 1386879724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386879724 |
| Entity Type | Individual |
| Full Name | DR. LYDIA MUSTAFIC |
| Credential | M.D. |
| Practice Address |
2710 Saint Francis Dr Ste 210 Waterloo IA 50702-5664 |
| Mailing Address |
1306 Versailles Rd Ste 120 Lexington KY 40504-1796 |
| Practice Telephone | 3192725000 |
| Mailing Telephone | (859) 259-0717 |
| Mailing Fax Number | 8592547874 |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2017-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 44461 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100179770 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1306 Versailles Rd, Ste 120, Lexington, KY 405041796 | 8592590717 | 8592547874 |
| Street Address |
2710 SAINT FRANCIS DR STE 210 |
| City | WATERLOO |
| State | IA |
| Zip Code | 50702-5664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972985232 | Tiffany J Mcewan | Nurse Practitioner | 2710 Saint Francis Dr Ste 210, Waterloo, IA 50702-5664 | 2015-06-23 |
| 1851708481 | Andrew Robert Green Luke | Family Medicine | 2710 Saint Francis Dr Ste 210, Waterloo, IA 50702-5664 | 2014-07-15 |
| 1477997468 | Elizabeth W Drelich | Counselor | 2710 Saint Francis Dr Ste 210, Waterloo, IA 50702-5664 | 2013-04-22 |
| 1538415518 | Rahil Shaikh | Family Medicine | 2710 Saint Francis Dr Ste 210, Waterloo, IA 50702-5664 | 2012-07-27 |
| 1578873980 | Christina Lynn Schultz | Counselor | 2710 Saint Francis Dr Ste 210, Waterloo, IA 50702-5664 | 2010-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684709 | Peoples Community Health Clinic, Inc | Clinic/Center | 425 1/2 East Ridgeway Ave., Waterloo, IA 50702 | 2020-09-23 |
| 1346867439 | Kinza Ali | Family Medicine | 2055 Kimball Avenue, Suite 101, Waterloo, IA 50702 | 2020-07-06 |
| 1073176533 | Sandeep Badyal | Family Medicine | Ne Ia Family Medicine Residency Program, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-19 |
| 1619530763 | Sophia Tariq Qureshi | Family Medicine | Ne Ia Medical Education Foundation, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-15 |
| 1659869915 | Alicia M Johnson | Advanced Practice Midwife | 439 King Street, Waterloo, IA 50702 | 2018-04-23 |
| 1427591411 | Alexandra E. Becker | Specialist/Technologist | 4157 Mourning Dove Drive, Waterloo, IA 50702 | 2016-11-23 |
| 1255793196 | Eastern Iowa Therapeutics PC | Physical Therapist | 1655 E San Marnan Dr, Ste A, Waterloo, IA 50702 | 2016-03-21 |
| 1972859288 | Noble Cedar Psychological Institute | Psychologist | 1425 W. 5th Street, Suite 1, Waterloo, IA 50702 | 2012-07-24 |
| 1417223363 | Rita Marie Menart | Counselor | 2101 Kimball Ave., Suite 138, Waterloo, IA 50702 | 2012-03-26 |
| 1336411685 | Jagpal Singh Suman | Hospitalist | 3421 West 9th Street, Waterloo, IA 50702 | 2012-02-02 |
| Find all providers in zip 50702 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346867439 | Kinza Ali | Family Medicine | 2055 Kimball Avenue, Suite 101, Waterloo, IA 50702 | 2020-07-06 |
| 1033777610 | Emily Rose Pursley | Family Medicine | Medical Arts Bldg., 2055 Kimball Ave. Suite 101, Waterloo, IA 50702-5070 | 2019-05-30 |
| 1609434281 | Shalini Chowdavarapu | Family Medicine | Ne Ia Family Practice Center, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702-5070 | 2019-05-30 |
| 1073176533 | Sandeep Badyal | Family Medicine | Ne Ia Family Medicine Residency Program, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-19 |
| 1619530763 | Sophia Tariq Qureshi | Family Medicine | Ne Ia Medical Education Foundation, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-15 |
| 1669826640 | Sapna Patel | Family Medicine | 2140 Logan Ave Ste C, Waterloo, IA 50703-1002 | 2016-04-15 |
| 1174752802 | Lane A Noble | Family Medicine | 2055 Kimball Ave Ste 100, Waterloo, IA 50702-5014 | 2009-07-01 |
| 1568698389 | Michelle Sarah Craig | Family Medicine | 2710 St. Francis Drive, Suite 210, Waterloo, IA 50702-5401 | 2009-06-08 |
| 1386651560 | David Robert Kobliska | Family Medicine | 2710 St.francis Dr, Waterloo, IA 50702-2081 | 2006-08-01 |
| 1740294644 | Henry Warren Snead | Family Medicine | 1114 Flammang Dr, Waterloo, IA 50702-4306 | 2006-07-28 |
| Find all providers in WATERLOO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.