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Organization

DES MOINES UNIVERSITY OSTEOPATHIC MEDICAL CENTER

Active
Other names
Des Moines University Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
PHILIP C. BLUMBERG (ADMINISTRATOR)
(515) 271-1574
Entity
Organization

Contact information

Practice address
3200 GRAND AVE, DES MOINES, IA 50312-4104
(515) 471-9243
(515) 471-9319
Mailing address
3200 GRAND AVE, DES MOINES, IA 50312-4104
(515) 471-9243
(515) 471-9319

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
IA
207Q00000X
Family Medicine Physician
Primary
IA
207R00000X
Internal Medicine Physician
IA
208100000X
Physical Medicine & Rehabilitation Physician
IA
2084P0800X
Psychiatry Physician
2085R0202X
Diagnostic Radiology Physician
IA
208D00000X
General Practice Physician
IA
213EP1101X
Primary Podiatric Medicine Podiatrist
IA
213ES0103X
Foot & Ankle Surgery Podiatrist
IA
225100000X
Physical Therapist
IA
225X00000X
Occupational Therapist
IA
363A00000X
Physician Assistant
IA
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0255166
IA
05
0255182
IA
01
CQ2071
RR MEDICARE
IA
Enumeration date
05/18/2006
Last updated
08/12/2022
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