Provider Demographics
NPI:1295842375
Name:ALDURRAH, RANA (MD)
Entity Type:Individual
Prefix:
First Name:RANA
Middle Name:
Last Name:ALDURRAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RANA
Other - Middle Name:
Other - Last Name:AL-DURRAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-6090
Mailing Address - Fax:515-643-6001
Practice Address - Street 1:5615 NW 86TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1738
Practice Address - Country:US
Practice Address - Phone:515-643-6090
Practice Address - Fax:515-643-6001
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-35310208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIA01Z1OtherJOHN DEERE
IA39105OtherWELLMARK
IA0463372Medicaid