Provider Demographics
NPI:1669480463
Name:SCHOSSOW, DARWIN (DO)
Entity Type:Individual
Prefix:
First Name:DARWIN
Middle Name:
Last Name:SCHOSSOW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5612 CODY DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-6393
Mailing Address - Country:US
Mailing Address - Phone:515-556-6022
Mailing Address - Fax:515-440-0041
Practice Address - Street 1:5612 CODY DR
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6393
Practice Address - Country:US
Practice Address - Phone:515-556-6022
Practice Address - Fax:515-440-0041
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO02249207P00000X
IA02249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA6051946Medicaid
IA6051946Medicaid
IAI14104Medicare ID - Type Unspecified