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NPI Code Detail

MEDICARE: CAROLE MARIE MCCLANAHAN MD, MPH

MEDICARE:   CAROLE MARIE MCCLANAHAN  MD, MPH
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
1207N00000XDermatology PhysicianMD-56000IA

General Provider Information

NPI Number : 1578980835
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLE MARIE MCCLANAHAN MD, MPH
Provider Business Mailing Address
First Line : PO BOX 424
Second Line :
City : DES MOINES
State : IA
Zip : 50302-0424
Country : US
Telephone Number : 515-875-9925
Fax Number :
Provider Business Practice Location Address
First Line : 830 NE ALICES RD
Second Line :
City : WAUKEE
State : IA
Zip : 50263-8857
Country : US
Telephone Number : 515-875-9766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2014
Last Update Date : 03/06/2026

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