MEDICARE: CHRISTIAN PETER LEDET MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician	32573	IA
2	208VP0014X	Interventional Pain Medicine Physician	MD-32573	IA

General Provider Information

NPI Number	:	1154385557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN PETER LEDET MD

Provider Business Mailing Address
First Line	:	2425 WESTOWN PKWY STE 100
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1425
Country	:	US
Telephone Number	:	515-267-1819
Fax Number	:	515-401-1313

Provider Business Practice Location Address
First Line	:	2425 WESTOWN PKWY STE 100
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1425
Country	:	US
Telephone Number	:	515-267-1819
Fax Number	:	515-401-1313

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	10/26/2022

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