Bordewick, Dianna L

Bordewick, Dianna L is an individual health care provider with primary practice located at 2253 W Mason St Ste 100 , Green Bay WI 54303-4706. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Bordewick, Dianna L can be contacted via phone (920) 327-7000.

Contact Information

Primary practice address
2253 W Mason St Ste 100 Green Bay WI 54303-4706
Phone: (920) 327-7000
Fax: (920) 327-7005
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 41090 Wisconsin

Profile Details

NPI number 1790720100
LBN Legal business name Bordewick, Dianna L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2006
Last updated Aug 28th, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790720100 NPPES
Wisconsin MEDICAID 32562600
Wisconsin Other 180043984
Wisconsin MEDICAID 104390165

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