Bertram, Dale T
Bertram, Dale T is an individual health care provider with primary practice located at 611 Honey Bear Ct , Waupaca WI 54981-1071. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Bertram, Dale T can be contacted via phone (608) 516-9278.Contact Information
Primary practice address
611 Honey Bear Ct
Waupaca WI 54981-1071
Phone: (608) 516-9278
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 25540 | Wisconsin |
Profile Details
| NPI number | 1871550970 |
|---|---|
| LBN Legal business name | Bertram, Dale T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2006 |
| Last updated | Mar 18th, 2013 - about 13 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871550970 | NPPES |
| Wisconsin | MEDICAID | 30688500 |
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