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NPI Code Detail

MEDICARE: DAVID SCOTT KERMODE D.O.

MEDICARE: DAVID SCOTT KERMODE D.O.
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
1208600000XSurgery PhysicianR4H42MO
2208600000XSurgery Physician02888IA
3208600000XSurgery PhysicianDO-02888IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
172045OTHERIABLUECROSS BLUE SHIELD - IOWA
2906555OTHERMOHEALTHLINK
3158283OTHERMOANTHEM BLUE CROSS BLUE SHIELD MISSOURI

General Provider Information

NPI Number : 1255303400
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID SCOTT KERMODE D.O.
Provider Business Mailing Address
First Line : PO BOX 1475
Second Line :
City : DES MOINES
State : IA
Zip : 50305-1475
Country : US
Telephone Number : 515-643-6400
Fax Number : 515-643-5816
Provider Business Practice Location Address
First Line : 411 LAUREL ST STE 3300
Second Line :
City : DES MOINES
State : IA
Zip : 50314-3027
Country : US
Telephone Number : 515-643-6400
Fax Number : 515-643-5816
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 09/28/2018

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Directions to “ DAVID SCOTT KERMODE D.O.” Practice Location

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