Healthcare Provider Details
I. General information
NPI: 1073957395
Provider Name (Legal Business Name): KATELYN MAUREEN BUHROW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/18/2013
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5950 UNIVERSITY AVE STE 205
WEST DES MOINES IA
50266-8231
US
IV. Provider business mailing address
PO BOX 424
DES MOINES IA
50302-0424
US
V. Phone/Fax
- Phone: 515-875-9290
- Fax: 515-875-9291
- Phone: 515-875-9255
- Fax: 515-875-9223
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MD460355 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MD-48284 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: