IndividualActive
Brian Waggoner, M.D.
NPI 1679544548 · Pediatrics Physician · Clive, IA
Provider details
- NPI number
- 1679544548
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 28129 (IA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2555 Berkshire Pkwy Ste a
Clive, IA 50325-4646
Phone: (515) 987-0051
Fax: (515) 987-0054
Approximate (ZIP-level) locationGet directions
Mailing address
2555 Berkshire Pkwy Ste a
Clive, IA 50325-4646
Registry dates
- Enumerated
- 2006-01-30
- Last updated
- 2016-12-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.