Individual
ED DEHAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
126 NORTH 10TH ST, FORT DODGE, IA 50501
(515) 576-6500
Mailing address
126 NORTH 10TH ST, FORT DODGE, IA 50501
(515) 576-6500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22648
IA
Other
Enumeration date
01/31/2006
Last updated
07/27/2007
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