Provider Demographics
NPI:1689669558
Name:NUSS, FREDERICK S (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:S
Last Name:NUSS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6800 LAKE DRIVE
Mailing Address - Street 2:STE 250
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-2504
Mailing Address - Country:US
Mailing Address - Phone:515-875-9925
Mailing Address - Fax:515-875-9923
Practice Address - Street 1:5950 UNIVERSITY AVE
Practice Address - Street 2:STE 135
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8216
Practice Address - Country:US
Practice Address - Phone:515-875-9795
Practice Address - Fax:515-875-9496
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2015-09-02
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Provider Licenses
StateLicense IDTaxonomies
IAMD-21385208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA01938Medicare UPIN