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Contact Information

GREATER DES MOINES DERMATOLOGY PC
2424 128TH ST
NW 128TH STREET
URBANDALE, IA50323-1816
 Phone: 515-243-8676
 Fax: 515-243-0487
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for GREATER DES MOINES DERMATOLOGY PC

NPI Number 1730188160
LBN Legal business name GREATER DES MOINES DERMATOLOGY PC
Authorized official TIMOTHY ABRAHAMSON - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 07/18/2005
Last updated 03/24/2008 - About 18 years ago
Identifiers
IA License # 33182
IA Medicaid 0255075
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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