Provider Demographics
NPI:1326236316
Name:MONSOD BORROMEO, TERESA PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:PATRICIA
Last Name:MONSOD BORROMEO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:PATRICIA
Other - Last Name:MONSOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 PLEASANT ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1453
Mailing Address - Country:US
Mailing Address - Phone:515-241-6500
Mailing Address - Fax:515-241-8911
Practice Address - Street 1:1215 PLEASANT ST
Practice Address - Street 2:SUITE 300
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1453
Practice Address - Country:US
Practice Address - Phone:515-241-6500
Practice Address - Fax:515-241-8911
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA373112080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1326236316Medicaid
175150024OtherMEDICARE