Individual
VIJAYA L. DHANWADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2231 NW 108TH ST, DES MOINES, IA 50325-3729
(515) 334-7524
(515) 334-7528
Mailing address
1111 6TH AVE, MERCY MEDICAL CENTER - PATHOLOGY DEPARTMENT, DES MOINES, IA 50314-2610
(515) 247-3115
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
26181
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1044602
—
IA
01
—
39054
WELLMARK BC/BS
IA
Enumeration date
08/16/2006
Last updated
07/08/2007
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