| Mangil Seo MD PC | |
|
4505 Sw 9th St Des Moines IA 50315-3939 | |
| (515) 287-7777 | |
| (515) 287-7114 |
| Full Name | Mangil Seo MD PC |
|---|---|
| Speciality | Clinic/center |
| Location | 4505 Sw 9th St, Des Moines, Iowa |
| Authorized Official Name and Position | Mangil Seo (OWNER) |
| Authorized Official Contact | 5152877111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mangil Seo MD PC 4505 Sw 9th St Des Moines IA 50315-3939 Ph: (515) 287-7777 | Mangil Seo MD PC 4505 Sw 9th St Des Moines IA 50315-3939 Ph: (515) 287-7777 |
| NPI Number | 1649451857 |
|---|---|
| Provider Enumeration Date | 11/15/2007 |
| Last Update Date | 11/15/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649451857 | NPI | - | NPPES |
| 3080598 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 19652 (Iowa) | Primary |
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