Daryl Erwin Doorenbos, M.D.
Individual provider Active NPI Family Medicine Physician · Le Mars, IA
NPI 1821085200 · NPPES record last updated Sep 5, 2007
Key facts
- NPI
- 1821085200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 18357 (IA)
- Practice address
- 194 6TH Ave NE
Le Mars, IA 51031-3716 - Phone
- (712) 546-3640
- Fax
- (712) 546-3644
- NPI assigned
- Sep 30, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Interoperability endpoints
- daryl.doorenbos2@avera.sdhealthlink.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 18357 | IA | Yes |
Addresses
Primary practice location
194 6TH Ave NE
Le Mars, IA 51031-3716
Mailing address
1775 7TH Ave SE
Le Mars, IA 51031-2869
Phone (712) 546-3640
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07396 | Other | IA | WELLMARK BC/BS |
| 0073965 | Medicaid | IA |
Other providers in Le Mars, IA
- Tyler James Dejong
- Tracy May Delao
- Lindsey Denouden
- Rebecca Ann Deruyter
- Kelley Dickey Cuddy
- Hannah Marie Dreckman
- Kayley Diane Dresback
- Adam David Erdmann
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- Family First Dental Associates of Primghar, P.C.
All providers in Le Mars, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.