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General NPI Number Information
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NPI Number | 1093795411
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Entity Type | Organization
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Legal Business Name | WEST GRAND MEDICAL ASSOCIATES,P.C.
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 119 19TH ST STE 106
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City | WEST DES MOINES
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State | IA
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Zip | 50265-4226
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Country | US
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Telephone | 515-226-0112
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Fax | 515-226-0208
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Provider Business Mailing Address
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Address Line | 119 19TH ST STE 106
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City | WEST DES MOINES
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State | IA
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Zip | 50265-4226
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Country | US
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Telephone | 515-226-0112
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Fax | 515-226-0208
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MR. ROBERT H MAJOR
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Credential | MD
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Telephone | 515-226-0112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25404
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 001418
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 3475
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License Number State | IA
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