Individual
DR. MICHAEL JAMES VERSACKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1212 PLEASANT ST, SUITE 202, DES MOINES, IA 50309-1414
(515) 243-1580
(515) 243-1442
Mailing address
1212 PLEASANT ST, SUITE 202, DES MOINES, IA 50309-1414
(515) 243-1580
(515) 243-1442
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
19328
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0041798
—
IA
05
—
0179994
—
IA
Enumeration date
05/04/2006
Last updated
05/26/2010
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