Provider Demographics
NPI:1528705001
Name:VON TERSCH, LYDIA ELYSE (DO)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:ELYSE
Last Name:VON TERSCH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LYDIA
Other - Middle Name:ELYSE
Other - Last Name:SHARP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 PLEASANT ST # B5
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1406
Mailing Address - Country:US
Mailing Address - Phone:515-241-4497
Mailing Address - Fax:
Practice Address - Street 1:1200 PLEASANT ST # B5
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1406
Practice Address - Country:US
Practice Address - Phone:515-241-4497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-12442208000000X
IADO-06953208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics