Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 32797 | IA |
NPI | 1063415164 |
---|---|
Provider Name | Dr. Sameer A Yaseen |
First Address | Des Moines, IA 50309-4538 |
Second Address | Des Moines, IA 50309-4538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 14/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0229799 | (05) | IA |
H40511 | (02) | IA |