Healthcare Provider Details

I. General information

NPI: 1700306636
Provider Name (Legal Business Name): ALEXANDER MENNING DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PENN AVE STE 411
DES MOINES IA
50316-2367
US

IV. Provider business mailing address

17628 BERKSHIRE PKWY
CLIVE IA
50325-2626
US

V. Phone/Fax

Practice location:
  • Phone: 515-265-1300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5101023538
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number05517
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: