Individual
MICHELE L DIKKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
200 MAIN STREET, GUTTENBERG, IA 52052
(563) 252-1121
(563) 252-3955
Mailing address
PO BOX 550, GUTTENBERG, IA 52052-0550
(563) 252-1121
(563) 252-3955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03015
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1142539
—
IA
01
—
IB2804006
PTAN
IA
Enumeration date
10/14/2005
Last updated
04/03/2017
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