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1164408548

NPI Code Detail

MEDICARE: DR. MAXWELL S COSMIC MD

MEDICARE: DR. MAXWELL S COSMIC 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	34992	IN
2	207RP1001X	Pulmonary Disease Physician	34992	IN
3	207RP1001X	Pulmonary Disease Physician	MD-34992	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	239198	OTHER	IA	MIDLAND'S CHOICE
2	165260	OTHER	IA	COVENTRY
3	IA0139	OTHER	IA	UHC OF THE RIVER VALLEY
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1907221	OTHER	IA	UNITED HEALTHCARE
6	34116	OTHER	IA	WELLMARK

General Provider Information

NPI Number	:	1164408548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAXWELL S COSMIC MD

Provider Business Mailing Address
First Line	:	PO BOX 1475
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50305-1475
Country	:	US
Telephone Number	:	515-643-7900
Fax Number	:	515-643-7901

Provider Business Practice Location Address
First Line	:	411 LAUREL ST STE A120
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50314-3027
Country	:	US
Telephone Number	:	515-643-7900
Fax Number	:	515-643-7901

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

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	11/11/2020

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Directions to “ DR. MAXWELL S COSMIC MD” Practice Location

Language	Start Address	Practice Location

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