| Dewitt Family Practice, Pllc | |
|
1415 11th St Ste C De Witt IA 52742-1292 | |
| (563) 659-6090 | |
| (866) 493-4063 |
| Full Name | Dewitt Family Practice, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1415 11th St Ste C, De Witt, Iowa |
| Authorized Official Name and Position | Michael Cloos (OWNER) |
| Authorized Official Contact | 5637263724 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dewitt Family Practice, Pllc 1415 11th St Ste C De Witt IA 52742-1292 Ph: (563) 659-6090 | Dewitt Family Practice, Pllc 1415 11th St Ste C De Witt IA 52742-1292 Ph: (563) 659-6090 |
| NPI Number | 1659142271 |
|---|---|
| Provider Enumeration Date | 01/11/2024 |
| Last Update Date | 01/11/2024 |
| Medicare PECOS PAC ID | 1850738592 |
|---|---|
| Medicare Enrollment ID | O20240318001895 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659142271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael P Cloos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750761383 PECOS PAC ID: 8820301773 Enrollment ID: I20180630000151 |
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