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General NPI Number Information
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NPI Number | 1750474318
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Entity Type | Organization
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Legal Business Name | MYRIE & ASSOCIATES
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 06/04/2010
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Provider Practice Location Address
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Address Line | 974 73RD ST SUITE 25
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City | WINDSOR HEIGHTS
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State | IA
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Zip | 50324-1024
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Country | US
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Telephone | 515-225-3355
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Fax | 515-222-1828
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Provider Business Mailing Address
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Address Line | PO BOX 8057
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City | DES MOINES
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State | IA
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Zip | 50301-8057
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Country | US
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Telephone | 515-225-3355
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Fax | 515-222-1828
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENVILLE A MYRIE
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Credential | MD
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Telephone | 515-490-8950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 34603
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License Number State | IA
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