Organization
DES MOINES PEDIATRIC & ADOLESCENT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROB FORNOFF M.D. (OWNER)
(515) 255-3181
Entity
Organization
Contact information
Practice address
2301 BEAVER AVE, DES MOINES, IA 50310-3903
(515) 255-3181
(515) 255-9392
Mailing address
2301 BEAVER AVE, DES MOINES, IA 50310-3903
(515) 255-3181
(515) 255-9392
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
04/30/2008
Last updated
12/10/2020
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