Individual
KATHLEEN OPDEBEECK MACMENAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1026 A AVE NE, CEDAR RAPIDS, IA 52402-5036
(319) 369-7908
Mailing address
PO BOX 9306, DES MOINES, IA 50306-9306
(515) 471-9373
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
24133
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0217869
—
IA
Enumeration date
12/27/2006
Last updated
07/08/2007
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