Provider Demographics
NPI:1396724878
Name:MOLIS, WHITNEY E (MD)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:E
Last Name:MOLIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:E
Other - Last Name:MOLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1212 PLEASANT ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1414
Mailing Address - Country:US
Mailing Address - Phone:515-244-7229
Mailing Address - Fax:515-244-7233
Practice Address - Street 1:1212 PLEASANT ST
Practice Address - Street 2:SUITE 110
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1414
Practice Address - Country:US
Practice Address - Phone:515-244-7229
Practice Address - Fax:515-244-7233
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36887207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I07184Medicare UPIN