Provider Demographics
NPI:1376533802
Name:DUBOIS, MARGARET M (DPM)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:M
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54702-1510
Mailing Address - Country:US
Mailing Address - Phone:608-785-0940
Mailing Address - Fax:
Practice Address - Street 1:325 BUTTS AVENUE
Practice Address - Street 2:
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-1412
Practice Address - Country:US
Practice Address - Phone:608-372-5951
Practice Address - Fax:608-372-3436
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI731213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43221900Medicaid
U62535Medicare UPIN