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NPI Code Detail

MEDICARE: MRS. SAMANTHA MADELINE WHEI FITZGERALD MD

MEDICARE: MRS. SAMANTHA MADELINE WHEI FITZGERALD MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD-55541IA

General Provider Information

NPI Number : 1649912627
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SAMANTHA MADELINE WHEI FITZGERALD MD
Provider Business Mailing Address
First Line : 515 2ND ST S
Second Line :
City : COGGON
State : IA
Zip : 52218-9405
Country : US
Telephone Number : 319-899-9716
Fax Number :
Provider Business Practice Location Address
First Line : 709 W MAIN ST
Second Line :
City : MANCHESTER
State : IA
Zip : 52057-1526
Country : US
Telephone Number : 563-927-7777
Fax Number : 563-927-7935
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2022
Last Update Date : 02/05/2026

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