Provider Demographics
NPI:1073705760
Name:PEASE, CAROLYN SU-YING (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:SU-YING
Last Name:PEASE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1111 6TH AVENUE
Mailing Address - Street 2:MERCY MEDICAL CENTER
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314
Mailing Address - Country:US
Mailing Address - Phone:515-643-8533
Mailing Address - Fax:515-643-8911
Practice Address - Street 1:1111 6TH AVENUE
Practice Address - Street 2:MERCY MEDICAL CENTER
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314
Practice Address - Country:US
Practice Address - Phone:515-643-8533
Practice Address - Fax:515-643-8911
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2011-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN49470207ZP0102X
IA37606207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology