Healthcare Provider Details

I. General information

NPI: 1194392829
Provider Name (Legal Business Name): SAVANNAH MARKER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2021
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W HUTCHINGS ST
WINTERSET IA
50273-2109
US

IV. Provider business mailing address

300 W HUTCHINGS ST
WINTERSET IA
50273-2109
US

V. Phone/Fax

Practice location:
  • Phone: 515-462-2950
  • Fax: 515-462-4371
Mailing address:
  • Phone: 515-462-2950
  • Fax: 515-462-4371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR-12187
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: