Individual
DR. DOUGLAS JAE MIEDEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
600 9TH AVE N, SIBLEY, IA 51249-1012
(712) 754-3658
(712) 754-2634
Mailing address
600 9TH AVE N, P.O. BOX 277, SIBLEY, IA 51249-1012
(712) 754-3658
(712) 754-2634
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2364
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115478
UCARE
MN
01
—
167177
HOME HEALTH MEDICARE
IA
05
—
2049429
—
IA
05
—
537072800
—
MN
Enumeration date
08/15/2005
Last updated
07/01/2013
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