Healthcare Provider Details

I. General information

NPI: 1750376034
Provider Name (Legal Business Name): DUANGCHAI NARAWONG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 PLEASANT ST STE 116
DES MOINES IA
50309-1409
US

IV. Provider business mailing address

1200 PLEASANT ST SOUTH 2 ROOM 236
DES MOINES IA
50309-1406
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-6544
  • Fax: 515-241-6533
Mailing address:
  • Phone: 515-241-6228
  • Fax: 515-241-8685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number26968
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number26968
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: