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Physicians Internal Medicine

Provider NPI: 1750498077

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 920-235-4910  Fax: 920-237-2043

Business Mailing Address:
PO BOX 9  WINNEBAGO, WI 54985-0009 US
Tel: 920-235-4910  Fax: 920-237-2043

NPI Information:
NPI: 1750498077
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Internal Medicine
Psychiatric Hospital

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207R00000X





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