Healthcare Provider Details

I. General information

NPI: 1205052776
Provider Name (Legal Business Name): HAMZA AHMAD ALSAYOUF M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 12/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 LAUREL ST SUITE 1200
DES MOINES IA
50314-3034
US

IV. Provider business mailing address

PO BOX 4925
DES MOINES IA
50305-4925
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-5454
  • Fax: 515-643-5460
Mailing address:
  • Phone: 515-643-5454
  • Fax: 515-643-5460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number38240
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: