Provider Demographics
NPI:1588769822
Name:KOELE, SHARON L (MD)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:L
Last Name:KOELE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2327 70TH ST.
Mailing Address - Street 2:IOWA PSYCHIATRY, LLC
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-4825
Mailing Address - Country:US
Mailing Address - Phone:515-270-2242
Mailing Address - Fax:515-777-1950
Practice Address - Street 1:2327 70TH ST.
Practice Address - Street 2:IOWA PSYCHIATRY, LLC
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4825
Practice Address - Country:US
Practice Address - Phone:515-270-2242
Practice Address - Fax:515-777-1950
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA291842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA36502OtherWELLMARK
IA2109926Medicaid
IAI12340Medicare ID - Type Unspecified
IA36502OtherWELLMARK