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Individual

DR. BASAVIAH CHANDRAMOULI

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
330 LAUREL ST, SUITE 2200, DES MOINES, IA 50314-3034
(515) 288-1097
(515) 288-2847
Mailing address
707 38TH ST, WEST DES MOINES, IA 50265-3177
(515) 223-1511

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
19084
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1093849
IA
Enumeration date
11/17/2005
Last updated
07/08/2007
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