Individual
OPAS ANOTHAYANONTHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2213 GRAND AVE, DES MOINES, IA 50312-5305
(515) 237-3974
(515) 237-3979
Mailing address
2213 GRAND AVE, DES MOINES, IA 50312-5305
(515) 237-3974
(515) 883-2692
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
18895
IA
Other
Enumeration date
08/12/2005
Last updated
07/08/2007
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