Provider Demographics
NPI:1588628101
Name:SHRECK, ROBERT R (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:SHRECK
Suffix:
Gender:M
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 1:1221 PLEASANT STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309
Mailing Address - Country:US
Mailing Address - Phone:515-282-2921
Mailing Address - Fax:515-282-1035
Practice Address - Street 1:1221 PLEASANT ST STE 100
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1424
Practice Address - Country:US
Practice Address - Phone:515-282-2921
Practice Address - Fax:515-282-1035
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2022-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA19828207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0160143Medicaid
IA0160143Medicaid
IAA01446Medicare UPIN
IA58988Medicare ID - Type Unspecified