Provider Demographics
NPI:1982684759
Name:MUNRO, BERNARD JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:JAMES
Last Name:MUNRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 WESTOWN PKWY
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1427
Mailing Address - Country:US
Mailing Address - Phone:515-267-8300
Mailing Address - Fax:515-267-8872
Practice Address - Street 1:2501 WESTOWN PKWY
Practice Address - Street 2:SUITE 1101
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1427
Practice Address - Country:US
Practice Address - Phone:515-267-8300
Practice Address - Fax:515-267-8872
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA28624207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2084640Medicaid
IA16847OtherIOWA BLUE CROSS/BLUE SHIELD
IAF30138Medicare UPIN
IAI11522Medicare ID - Type Unspecified