Healthcare Provider Details

I. General information

NPI: 1922487941
Provider Name (Legal Business Name): XIAOPING HE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 NW 114TH ST STE 342
CLIVE IA
50325-7036
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-222-7600
  • Fax: 515-222-7601
Mailing address:
  • Phone: 515-222-7600
  • Fax: 515-222-7601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN#21342
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD-48138
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberR-11071
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: