Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 2150 | IA |
NPI | 1548362015 |
---|---|
Provider Name | Cheryl E Child |
First Address | Des Moines, IA 50312-2012 |
Second Address | Des Moines, IA 50309-3332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D46551 | (02) | IA |