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Organization
PARTNERS IN PEDIATRICS PC
Active
Organization
PARTNERS IN PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE M CLARK MD (PHYSICIAN PRESIDENT)
(319) 393-0110
Entity
Organization
Contact information
Practice address
4205 GLASS RD NE, CEDAR RAPIDS, IA 52402
(319) 393-0110
(319) 393-0184
Mailing address
4205 GLASS RD NE, CEDAR RAPIDS, IA 52402
(319) 393-0110
(319) 393-0184
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
30509
IA
208000000X
Pediatrics Physician
30559
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1123166
—
IA
05
—
2123158
—
IA
01
—
24222
WELLMARK
IA
01
—
24232
WELLMARK
IA
Enumeration date
07/26/2006
Last updated
08/22/2020
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