Individual
PHILIP J COLLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
411 LAUREL ST, SUITE C100, DES MOINES, IA 50314-3017
(515) 643-5168
Mailing address
1055 6TH AVE, SUITE 200, DES MOINES, IA 50314-2607
(515) 643-8672
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
27802
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1167379
—
IA
01
—
40915
WELLMARK OF IOWA
IA
Enumeration date
11/01/2006
Last updated
07/08/2007
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