Provider Demographics
NPI:1841220290
Name:KUNZE, KENT E (MD)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:E
Last Name:KUNZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:939 OFFICE PARK RD
Mailing Address - Street 2:STE 200
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2538
Mailing Address - Country:US
Mailing Address - Phone:515-288-5570
Mailing Address - Fax:515-440-3388
Practice Address - Street 1:939 OFFICE PARK RD
Practice Address - Street 2:STE 200
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2538
Practice Address - Country:US
Practice Address - Phone:515-288-5570
Practice Address - Fax:515-440-3388
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA253212084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0272500Medicaid
IA42105384450265A008OtherTRIWEST
IA27250OtherWELLMARK BLUE CROSS
IA35533OtherMIDLANDS CHOICE
IAD89655Medicare UPIN
IA0272500Medicaid