Healthcare Provider Details

I. General information

NPI: 1659587202
Provider Name (Legal Business Name): GREGORY ALAN SCHMUNK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2903 160TH ST
URBANDALE IA
50323-2237
US

IV. Provider business mailing address

2903 160TH ST
URBANDALE IA
50323-2237
US

V. Phone/Fax

Practice location:
  • Phone: 515-710-2852
  • Fax:
Mailing address:
  • Phone: 515-710-2852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License NumberG66773
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number35738
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: