Goetz, Cameron A
Goetz, Cameron A is an individual health care provider with primary practice located at 339 Reed Ave , Manitowoc WI 54220-2020. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Goetz, Cameron A can be contacted via phone (920) 320-8600.Contact Information
Primary practice address
339 Reed Ave
Manitowoc WI 54220-2020
Phone: (920) 320-8600
Fax: (920) 320-8662
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2345-057 | Wisconsin |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 2345-057 | Wisconsin |
Profile Details
| NPI number | 1932120607 |
|---|---|
| LBN Legal business name | Goetz, Cameron A |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2006 |
| Last updated | Oct 17th, 2011 - about 15 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 | 1932120607 | NPPES |
| Other | P00241039 | RAILROAD MEDICARE | |
| Other | Q23775 | RAILROAD MEDICARE | |
| Other | 29439 | RAILROAD MEDICARE | |
| MEDICAID | 43576700 | RAILROAD MEDICARE |
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