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Individual

DR. DONALD RICHARD WIRTANEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
202 N MADISON ST, BLOOMFIELD, IA 52537-1425
(641) 664-1400
(641) 664-1410
Mailing address
202 N MADISON ST, BLOOMFIELD, IA 52537-1425
(641) 664-1400
(641) 664-1410

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
82100
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1184623985
MEDICARE
IA
05
1821295494
IA
05
242195006
MO
Enumeration date
07/14/2005
Last updated
06/04/2010
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