Provider Demographics
NPI:1205832110
Name:STUMPHY, DEE M (MD)
Entity Type:Individual
Prefix:
First Name:DEE
Middle Name:M
Last Name:STUMPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:865 LINCOLN RD
Practice Address - Street 2:STE 200
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4159
Practice Address - Country:US
Practice Address - Phone:563-344-8600
Practice Address - Fax:563-344-2967
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA21430208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
034786OtherHEALTH ALLIANCE
IA0156OtherJOHN DEERE HEALTH PLAN
19881OtherIOWA HEALTH SOLUTIONS
29873OtherWELLMARK BC/BS
IA4164251Medicaid
IA4164251Medicaid
IA0156OtherJOHN DEERE HEALTH PLAN