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Individual

DR. JOEL PHILIP VANDER MEIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
5900 NW 86TH ST, STE 100, JOHNSTON, IA 50131-2284
(515) 276-6133
(515) 334-7356
Mailing address
5900 NW 86TH ST, STE 100, JOHNSTON, IA 50131-2284
(515) 276-6133
(515) 334-7356

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3420
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790754695
IA
01
P00810887
RR MEDICARE
IA
Enumeration date
03/15/2006
Last updated
11/08/2016
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