Individual
TARA J FEDERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6800 LAKE DR STE 260, WEST DES MOINES, IA 50266-2504
(515) 630-5022
(515) 630-5026
Mailing address
6800 LAKE DR STE 260, WEST DES MOINES, IA 50266-2504
(515) 630-5022
(515) 630-5026
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
39579
IA
208000000X
Pediatrics Physician
R-8408
IA
Other
Enumeration date
06/24/2008
Last updated
07/30/2020
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