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:
Health care specialties
| Specialty | Code | License # | 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 11 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 | 1003986845 | NPPES |
| Wisconsin | MEDICAID | 1003986845 |
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