Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 23788 | IA |
NPI | 1164513560 |
---|---|
Provider Name | Neil Mandsager |
First Address | Des Moines, IA 50314 |
Second Address | Des Moines, IA 50314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 18/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
36604 | WELLMARK (01) | IA |
4096735 | (05) | IA |
E59849 | (02) | IA |