Provider Demographics
NPI:1295727915
Name:MORATZ, ROBERT J (DPM)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:MORATZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2213 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-5305
Mailing Address - Country:US
Mailing Address - Phone:515-237-3974
Mailing Address - Fax:515-883-2692
Practice Address - Street 1:815 OFFICE PARK RD
Practice Address - Street 2:SUITE 5
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2502
Practice Address - Country:US
Practice Address - Phone:515-225-0888
Practice Address - Fax:515-440-6600
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00683213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U73926Medicare UPIN
IA480031029Medicare PIN