Provider Demographics
NPI:1215920780
Name:CARLSTROM, THOMAS A (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:CARLSTROM
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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 1:1215 PLEASANT ST
Practice Address - Street 2:STE 608
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1416
Practice Address - Country:US
Practice Address - Phone:515-241-5760
Practice Address - Fax:515-241-8161
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2011-07-08
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Provider Licenses
StateLicense IDTaxonomies
IA19091207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA02369Medicare UPIN