Individual
KEN L CHEYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1212 PLEASANT ST, SUITE 406, DES MOINES, IA 50309-1453
(515) 241-8336
(515) 241-6465
Mailing address
1212 PLEASANT ST, SUITE 406, DES MOINES, IA 50309-1453
(515) 241-8336
(515) 241-6465
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
23873
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053305086
—
IA
05
—
1053305086
—
MO
01
—
53506
MEDICARE
—
Enumeration date
09/06/2005
Last updated
11/19/2011
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