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Individual

KENNETH JAMES MCCANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1215 PLEASANT ST, SUITE 303, DES MOINES, IA 50309-1416
(515) 241-4311
(515) 241-4320
Mailing address
1215 PLEASANT ST, SUITE 303, DES MOINES, IA 50309-1416
(515) 241-4311
(515) 241-4320

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
3772
IA
208000000X
Pediatrics Physician
DO00617
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DO00617
LICENSE
RI
05
KM67872
RI
Enumeration date
01/17/2006
Last updated
07/23/2009
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