Provider Demographics
NPI:1538146634
Name:WOLBERS, REGAN A (MD)
Entity type:Individual
Prefix:
First Name:REGAN
Middle Name:A
Last Name:WOLBERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 DELHI ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6389
Mailing Address - Country:US
Mailing Address - Phone:563-557-9111
Mailing Address - Fax:563-589-4046
Practice Address - Street 1:1515 DELHI ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6389
Practice Address - Country:US
Practice Address - Phone:563-557-9111
Practice Address - Fax:563-589-4046
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA34729207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine