Provider Demographics
NPI:1225074222
Name:LAMASTERS, TERESA L (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:L
Last Name:LAMASTERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 WESTOWN PKWY
Mailing Address - Street 2:STE 220
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-7707
Mailing Address - Country:US
Mailing Address - Phone:515-241-2250
Mailing Address - Fax:515-241-2265
Practice Address - Street 1:6600 WESTOWN PKWY
Practice Address - Street 2:STE 220
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-7707
Practice Address - Country:US
Practice Address - Phone:515-241-2250
Practice Address - Fax:515-241-2265
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA95114208600000X
IA37232208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1225074222Medicaid
CAZZZP4310ZMedicare PIN
IA719260354Medicare PIN
IAI20965Medicare PIN
IAI61102Medicare UPIN