NPI 1104357912 · live from the CMS NPI Registry
Frederick Royce Blodi, D.O.
Ophthalmology in West Des Moines, IA. National Provider Identifier 1104357912, active.
NPI record
| NPI | 1104357912 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology 207W00000X |
| Practice location | 5901 Westown Pkwy Ste 200, West Des Moines, IA 50266 |
| Practice phone | 515-225-3546 |
| Mailing address | 5901 Westown Pkwy, Ste 200, West Des Moines, IA 50266 |
| Enumerated | March 23, 2017 |
| Last updated | September 13, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology primary | 207W00000X | DO-05787 (IA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.