Healthcare Provider Details

I. General information

NPI: 1780700641
Provider Name (Legal Business Name): MARIA CRISTINA FILIPPONE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 CASADY DR
DES MOINES IA
50315-1828
US

IV. Provider business mailing address

1616 CASADY DR
DES MOINES IA
50315-1828
US

V. Phone/Fax

Practice location:
  • Phone: 515-991-2890
  • Fax: 714-475-0417
Mailing address:
  • Phone: 515-991-2890
  • Fax: 714-475-0417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3386
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: