Individual
WOOSUP MICHAEL PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5880 UNIVERSITY AVE, WEST DES MOINES, IA 50266-8220
(515) 633-3600
(515) 288-0840
Mailing address
5880 UNIVERSITY AVE, WEST DES MOINES, IA 50266-8220
(515) 633-3835
(515) 633-3838
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
35561
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0432393
—
IA
01
—
CD4547
RAILROAD MEDICARE GROUP #
IA
01
—
P00110411
RAILROAD MEDICARE
IA
Enumeration date
11/16/2005
Last updated
02/08/2012
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