Provider Demographics
NPI:1811984180
Name:PARMELEE, PAUL MARTIN (DO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:MARTIN
Last Name:PARMELEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33733 220TH ST
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-8868
Mailing Address - Country:US
Mailing Address - Phone:712-546-3670
Mailing Address - Fax:712-546-3674
Practice Address - Street 1:194 6TH AVE NE
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3716
Practice Address - Country:US
Practice Address - Phone:712-546-3670
Practice Address - Fax:712-546-3674
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02722207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA16208OtherWELLMARK BC/BS
IA4073163Medicaid
IA16208OtherWELLMARK BC/BS
IA162081Medicare ID - Type Unspecified