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Individual

DR. MICHAEL R LINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1200 PLEASANT STREET, BLANK CHILDREN'S HOSPITAL, DES MOINES, IA 50309-1453
(515) 241-5926
(515) 241-5127
Mailing address
1200 PLEASANT STREET, BLANK CHILDREN'S HOSPITAL, DES MOINES, IA 50309-1453
(515) 241-5926
(515) 241-5127

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
38276
IA
2080N0001X
Neonatal-Perinatal Medicine Physician
42848
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1881779684
IA
05
88803813
CO
Enumeration date
10/27/2006
Last updated
06/24/2009
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