Healthcare Provider Details

I. General information

NPI: 1215356589
Provider Name (Legal Business Name): ZOYA A. VORONOVICH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 6TH AVE STE B1
DES MOINES IA
50314-2610
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-358-0100
  • Fax: 515-358-0109
Mailing address:
  • Phone: 515-358-0100
  • Fax: 515-358-0109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number35282
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberRS2014-0455
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number12256647-1205
License Number StateUT
# 5
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD-50127
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: