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Individual

DARYL ERWIN DOORENBOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
194 6TH AVE NE, LE MARS, IA 51031-3716
(712) 546-3640
(712) 546-3644
Mailing address
1775 7TH AVE SE, LE MARS, IA 51031-2869
(712) 546-3640
(712) 546-3644

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18357
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0073965
IA
01
07396
WELLMARK BC/BS
IA
Enumeration date
09/30/2005
Last updated
09/05/2007
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