Dvorak, Eric Maitland

Dvorak, Eric Maitland is an individual health care provider with primary practice located at 744 S Webster Ave , Green Bay WI 54305-2487. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Dvorak, Eric Maitland can be contacted via phone (920) 445-7210.

Contact Information

Primary practice address
744 S Webster Ave Green Bay WI 54305-2487
Phone: (920) 445-7210
Fax: (920) 445-7229
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 49884-20 Wisconsin

Profile Details

NPI number 1003986845
LBN Legal business name Dvorak, Eric Maitland
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2006
Last updated May 6th, 2015 - about 9 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 1003986845 NPPES
Wisconsin MEDICAID 1003986845

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