Healthcare Provider Details

I. General information

NPI: 1164530358
Provider Name (Legal Business Name): DAVID M CRAVEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 04/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 LAUREL ST SUITE 2100
DES MOINES IA
50314-3034
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-8611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number23508
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: