Basic Information
| Provider Information | |||||||||
| NPI: | 1184062283 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAGILL | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | BRADLEY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4200 UNIVERSITY AVE STE 140 | ||||||||
| Address2: | |||||||||
| City: | WEST DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 502665945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152269810 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 12368 STRATFORD DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | CLIVE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503258149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152269810 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2013 | ||||||||
| LastUpdateDate: | 05/18/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0204X | MD60750923 | WA | N | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 2085R0204X | MD-46057 | IA | N | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 208600000X | R-9800 | IA | N | Allopathic & Osteopathic Physicians | Surgery | 2085R0202X | 46057 | IA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.