Organization
IOWA DIAGNOSTIC IMAGING & PROCEDURE L C
Active
Other names
Central Iowa Hospital Corp Member
Organization subpart
No
Provider details
NPI number
Authorized official
CHERI TIEDEMANN (BILLING OFFICE COORDINATOR)
(515) 961-0453
Entity
Organization
Contact information
Practice address
4200 UNIVERSITY AVE, SUITE 104, WEST DES MOINES, IA 50266-5945
(515) 961-0453
(515) 961-2714
Mailing address
4200 UNIVERSITY AVE, SUITE 104, WEST DES MOINES, IA 50266-5945
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2073326
—
IA
Enumeration date
03/04/2014
Last updated
07/01/2022
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