Provider Demographics
NPI:1780681551
Name:QUAM, STEVEN ROGER (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ROGER
Last Name:QUAM
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 1:5901 WESTOWN PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8218
Mailing Address - Country:US
Mailing Address - Phone:515-221-9222
Mailing Address - Fax:515-221-0575
Practice Address - Street 1:5901 WESTOWN PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8218
Practice Address - Country:US
Practice Address - Phone:515-221-9222
Practice Address - Fax:515-221-0575
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1759207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA50177OtherWELLMARK # (GROUP #)
IA2017178Medicaid
IACD9106OtherRR MEDICARE
IA50171OtherGROUP MEDICARE NUMBER
IAE46595Medicare UPIN
IA2017178Medicaid