Provider Demographics
NPI:1487640587
Name:PAULSEN, GRANT L (MD)
Entity type:Individual
Prefix:DR
First Name:GRANT
Middle Name:L
Last Name:PAULSEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7147 VISTA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-9313
Mailing Address - Country:US
Mailing Address - Phone:515-875-9925
Mailing Address - Fax:515-875-9923
Practice Address - Street 1:5950 UNIVERSITY AVE
Practice Address - Street 2:STE 205
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266
Practice Address - Country:US
Practice Address - Phone:515-875-9290
Practice Address - Fax:515-875-9291
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2018-06-22
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Provider Licenses
StateLicense IDTaxonomies
IA19164207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAE69549Medicare UPIN