Individual
DR. EDUARDO SEBASTIAN ANTEZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1215 PLEASANT ST, STE 414, DES MOINES, IA 50309-1416
(515) 241-5700
(515) 241-5775
Mailing address
1582 NW 131ST ST, CLIVE, IA 50325-7430
(515) 457-3886
(515) 457-3886
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036-102068
IL
207RC0000X
Cardiovascular Disease Physician
Primary
37277
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447363486
—
IA
01
—
P01371808
RR MEDICARE
IA
Enumeration date
08/16/2006
Last updated
11/26/2014
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