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1601 Nw 114th St Ste 347 Des Moines IA 50325-7046 | |
| (515) 224-1777 | |
| (515) 225-6750 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Pulmonary Disease |
| Location | 1601 Nw 114th St, Des Moines, Iowa |
| Authorized Official Name and Position | Michael C Witte (PRESIDENT) |
| Authorized Official Contact | 5152241777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1601 Nw 114th St Ste 347 Des Moines IA 50325-7046 Ph: (515) 224-1777 | 1601 Nw 114th St Ste 347 Des Moines IA 50325-7046 Ph: (515) 224-1777 |
| NPI Number | 1114905759 |
|---|---|
| Provider Enumeration Date | 01/04/2006 |
| Last Update Date | 06/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114905759 | NPI | - | NPPES |
| 15616 | Other | IA | WELLMARK |
| 015616 | Medicaid | IA |
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