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250 Laurel St Des Moines IA 50314-3024 | |
| (515) 643-4610 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 250 Laurel St, Des Moines, Iowa |
| Authorized Official Name and Position | David Vellinga (PRES/CEO) |
| Authorized Official Contact | 5152474278 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 645 Des Moines IA 50303-0645 Ph: (515) 643-4610 | 250 Laurel St Des Moines IA 50314-3024 Ph: (515) 643-4610 |
| NPI Number | 1356407605 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 11/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356407605 | NPI | - | NPPES |
| 40167 | Other | IA | WELLMARK BLUE CROSS |
| 0160705 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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