Healthcare Provider Details

I. General information

NPI: 1619389939
Provider Name (Legal Business Name): ANDREW MICHAEL WISHY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5950 UNIVERSITY AVE STE 231
WEST DES MOINES IA
50266-8233
US

IV. Provider business mailing address

PO BOX 424
DES MOINES IA
50302-0424
US

V. Phone/Fax

Practice location:
  • Phone: 515-875-9090
  • Fax:
Mailing address:
  • Phone: 515-875-9178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberDO-55564
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number2024026870
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: