Individual
TERI S FORMANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 W HUTCHINGS ST, WINTERSET, IA 50273
(515) 462-2373
Mailing address
300 W HUTCHINGS ST, WINTERSET, IA 50273-2109
(515) 462-2373
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
26239
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2083659
—
IA
Enumeration date
06/07/2006
Last updated
02/22/2021
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