Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 37311 | IA |
NPI | 1326236316 |
---|---|
Provider Name | Teresa Patricia Monsod Borromeo |
First Address | Des Moines, IA 50309-1453 |
Second Address | Des Moines, IA 50309-1453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2007 |
Last Update Date | 18/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1326236316 | (05) | IA |
175150024 | MEDICARE (01) |