Healthcare Provider Details

I. General information

NPI: 1356446983
Provider Name (Legal Business Name): MELISSA ASHBACHER MYERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA ASHBACHER

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 10/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 NW 36TH ST
ANKENY IA
50023-8411
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-358-7550
  • Fax: 515-358-7551
Mailing address:
  • Phone: 515-358-7550
  • Fax: 515-358-7551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-45499
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2008004922
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME 102109
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD-45499
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: