Depew, Michael R

Depew, Michael R is an individual health care provider with primary practice located at 1650 S. 41St St. Lakeshore Orthopedics, Manitowoc WI 54220. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Depew, Michael R can be contacted via phone (920) 682-5233.

Contact Information

Primary practice address
1650 S. 41St St. Lakeshore Orthopedics Manitowoc WI 54220
Phone: (920) 682-5233
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1419 Wisconsin

Profile Details

NPI number 1619032919
LBN Legal business name Depew, Michael R
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2006
Last updated Sep 24th, 2007 - about 19 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 1619032919 NPPES
Wisconsin MEDICAID 41956200

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