Individual
PATRICIA M MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1601 NW 114TH STREET, SUITE 247, CLIVE, IA 50325-7036
(515) 222-7000
(515) 222-7036
Mailing address
PO BOX 1475, DES MOINES, IA 50305-1475
(515) 222-7000
(515) 222-7036
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001205
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970014831
RR MEDICARE
IA
Enumeration date
01/06/2006
Last updated
08/29/2014
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