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General NPI Number Information
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NPI Number | 1992520548
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Entity Type | Organization
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Legal Business Name | VIRTUALMED IOWA
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 642 XAVIER PLACE
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City | AMES
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State | IA
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Zip | 50021
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Country | US
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Telephone | 515-686-9231
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Fax |
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Provider Business Mailing Address
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Address Line | 2407 SE DELAWARE AVE PMB 1115
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City | ANKENY
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State | IA
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Zip | 50021
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Country | US
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Telephone | 515-686-9231
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | RACHEL FREDERICK
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Credential | PA-C
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Telephone | 515-686-9231
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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 |
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License Number State |
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