Provider Demographics
NPI:1194723098
Name:DELOUIS, DONNA J (DO)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:J
Last Name:DELOUIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4116 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50311-3533
Mailing Address - Country:US
Mailing Address - Phone:515-274-1518
Mailing Address - Fax:515-274-6916
Practice Address - Street 1:4116 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50311-3533
Practice Address - Country:US
Practice Address - Phone:515-274-1518
Practice Address - Fax:515-274-6916
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA02217207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1044008Medicaid
IA1044008Medicaid
A03503Medicare UPIN