Provider Demographics
NPI:1467438713
Name:KATELMAN, HOWARD ROSS (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:ROSS
Last Name:KATELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 37TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-4306
Mailing Address - Country:US
Mailing Address - Phone:152-252-8955
Mailing Address - Fax:
Practice Address - Street 1:220 37TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-4306
Practice Address - Country:US
Practice Address - Phone:152-252-8955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20889207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA4276OtherMIDLANDS PROVIDER #
IA0083881Medicaid
IAIA0160OtherJOHN DEERE PROVIDER #
IA07981OtherBLUE SHIELD PROVIDER #
IA20889OtherTRICARE PROVIDER #
IAIA0160OtherJOHN DEERE PROVIDER #
IA07981Medicare ID - Type UnspecifiedMEDICARE PROVIDER #