Individual
KENNETH W ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6000 UNIVERSITY AVE, STE 100, WEST DES MOINES, IA 50266-8203
(515) 241-2500
(515) 241-2505
Mailing address
6000 UNIVERSITY AVE, STE 100, WEST DES MOINES, IA 50266-8203
(515) 241-2500
(515) 241-2505
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
19114
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0098137
—
IA
05
—
1851377899
—
IA
01
—
370033541
RR MEDICARE
IA
Enumeration date
12/21/2005
Last updated
03/07/2016
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