Healthcare Provider Details

I. General information

NPI: 1821058033
Provider Name (Legal Business Name): DARCY MARIE PUTZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 DELHI ST STE 100
DUBUQUE IA
52001-6320
US

IV. Provider business mailing address

1515 DELHI ST STE 100
DUBUQUE IA
52001-6320
US

V. Phone/Fax

Practice location:
  • Phone: 563-557-9111
  • Fax: 563-589-4046
Mailing address:
  • Phone: 563-557-9111
  • Fax: 563-589-4046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35178
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number46813 02
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: