Provider Demographics
NPI:1154328029
Name:PIEROTTI, STEPHEN EUGENE (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:EUGENE
Last Name:PIEROTTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 DELHI ST
Mailing Address - Street 2:STE 4200
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6319
Mailing Address - Country:US
Mailing Address - Phone:563-557-5999
Mailing Address - Fax:563-557-5990
Practice Address - Street 1:1500 DELHI ST
Practice Address - Street 2:STE 4200
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6319
Practice Address - Country:US
Practice Address - Phone:563-557-5999
Practice Address - Fax:563-557-5990
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36319207X00000X
IA27856207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
200016953OtherRR MEDICARE
IA0109975Medicaid
WI32024900Medicaid
F40627Medicare UPIN
IAI3194Medicare ID - Type Unspecified
WI0003Medicare PIN