Healthcare Provider Details
I. General information
NPI: 1154328029
Provider Name (Legal Business Name): STEPHEN EUGENE PIEROTTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/07/2005
Last Update Date: 07/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1500 DELHI ST STE 4200
DUBUQUE IA
52001-6319
US
IV. Provider business mailing address
1500 DELHI ST STE 4200
DUBUQUE IA
52001-6319
US
V. Phone/Fax
- Phone: 563-557-5999
- Fax: 563-557-5990
- Phone: 563-557-5999
- Fax: 563-557-5990
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 36319 |
| License Number State | WI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 27856 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: