Organization
PEDIATRIC CARDIOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASAVIAH CHANDRAMOULI M.D. (PRESIDENT)
(515) 288-1097
Entity
Organization
Contact information
Practice address
330 LAUREL ST, SUITE 2200, DES MOINES, IA 50314-3034
(515) 288-1097
(515) 288-2847
Mailing address
330 LAUREL ST, SUITE 2200, DES MOINES, IA 50314-3034
(515) 288-1097
(515) 288-2847
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0183046
—
IA
Enumeration date
11/17/2005
Last updated
08/22/2020
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