Dr Michael R Line, MD | |
1200 Pleasant Street, Blank Children's Hospital, Des Moines, IA 50309-1453 | |
(515) 241-5926 | |
(515) 241-5127 |
Full Name | Dr Michael R Line |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 1200 Pleasant Street, Des Moines, Iowa |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1881779684 | NPI | - | NPPES |
1881779684 | Medicaid | IA | |
88803813 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 38276 (Iowa) | Primary |
2080N0001X | Pediatrics - Neonatal-perinatal Medicine | 42848 (Colorado) | Secondary |
Entity Name | Central Iowa Hospital Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104879576 PECOS PAC ID: 1052229275 Enrollment ID: O20040128001102 |
Entity Name | Exemplar Care Plc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780270652 PECOS PAC ID: 9931516473 Enrollment ID: O20210329001301 |
Mailing Address | Practice Location Address |
---|---|
Dr Michael R Line, MD 1200 Pleasant Street, Blank Children's Hospital, Des Moines, IA 50309-1453 Ph: (515) 241-5926 | Dr Michael R Line, MD 1200 Pleasant Street, Blank Children's Hospital, Des Moines, IA 50309-1453 Ph: (515) 241-5926 |
Catherine P Mcneill, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1200 Pleasant St, Des Moines, IA 50309 Phone: 515-241-6611 Fax: 515-241-6635 | |
Dr. Lisa I Hardisty, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1200 Pleasant St, Des Moines, IA 50309 Phone: 515-241-5926 Fax: 515-241-5127 | |
Dr. Theresa Marie Wahlig, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1111 6th Ave, Des Moines, IA 50314 Phone: 515-643-8409 | |
Dr. Basaviah Chandramouli, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 330 Laurel St, Suite 2200, Des Moines, IA 50314 Phone: 515-288-1097 Fax: 515-288-2847 | |
Holley A Bzdega, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1200 Pleasant St, Neonatology, Des Moines, IA 50309 Phone: 515-241-4444 Fax: 515-241-5127 | |
Lexy Shantel Powell, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1200 Pleasant St, Des Moines, IA 50309 Phone: 515-241-6636 | |
Richard S Robus, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1221 Pleasant St, Suite 170, Des Moines, IA 50309 Phone: 515-241-4300 Fax: 515-241-4359 |