MEDICARE: CLAUDIA ADDY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	00504	IA

General Provider Information

NPI Number	:	1770239972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA ADDY

Provider Business Mailing Address
First Line	:	3818 PLEASANT ST
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50312-3223
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3818 PLEASANT ST
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50312-3223
Country	:	US
Telephone Number	:	515-255-3780
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2022
Last Update Date	:	02/25/2022

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Directions to “ CLAUDIA ADDY ” Practice Location

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