Provider Demographics
NPI:1548240948
Name:OPPERT, DAVID CARL (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CARL
Last Name:OPPERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 DELHI ST
Mailing Address - Street 2:STE 200
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6314
Mailing Address - Country:US
Mailing Address - Phone:563-557-7000
Mailing Address - Fax:563-589-4050
Practice Address - Street 1:1515 DELHI ST
Practice Address - Street 2:STE 200
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6314
Practice Address - Country:US
Practice Address - Phone:563-557-7000
Practice Address - Fax:563-589-4050
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA25461208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30729600Medicaid
IA0036376Medicaid
IA0036376Medicaid
IA23806Medicare ID - Type Unspecified