Healthcare Provider Details

I. General information

NPI: 1902859119
Provider Name (Legal Business Name): CHARLES F DENHART MD PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 GRAND AVE SUITE 102
DES MOINES IA
50312-5375
US

IV. Provider business mailing address

2213 GRAND AVE
DES MOINES IA
50312-5305
US

V. Phone/Fax

Practice location:
  • Phone: 515-283-1570
  • Fax: 515-883-2692
Mailing address:
  • Phone: 515-237-3974
  • Fax: 515-883-2692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number StateIA

VIII. Authorized Official

Name: CHARLES FORD DENHART
Title or Position: PRESIDENT
Credential: M.D.
Phone: 515-283-1570