Provider Demographics
NPI:1396730412
Name:SCHISSEL, DAWN MARIE (MD)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:SCHISSEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1701 22ND ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1443
Mailing Address - Country:US
Mailing Address - Phone:515-440-6622
Mailing Address - Fax:515-440-6698
Practice Address - Street 1:230 S 68TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8176
Practice Address - Country:US
Practice Address - Phone:515-471-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA27212207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAE67835Medicare UPIN