Bertagnoli, Mark W

Bertagnoli, Mark W is an individual health care provider with primary practice located at 835 S Van Buren St , Green Bay WI 54301-3526. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Bertagnoli, Mark W can be contacted via phone (920) 433-8360.

Contact Information

Primary practice address
835 S Van Buren St Green Bay WI 54301-3526
Phone: (920) 433-8360
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 40649-020 Wisconsin

Profile Details

NPI number 1669443610
LBN Legal business name Bertagnoli, Mark W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2006
Last updated Jul 13th, 2026 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669443610 NPPES
Michigan MEDICAID 4094435
Michigan MEDICAID 32539200

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