Groteluschen, David L

Groteluschen, David L is an individual health care provider with primary practice located at 1726 Shawano Ave , Green Bay WI 54303-3216. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Groteluschen, David L can be contacted via phone (920) 884-3135.

Contact Information

Primary practice address
1726 Shawano Ave Green Bay WI 54303-3216
Phone: (920) 884-3135
Fax: (920) 884-3144
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 44953 Wisconsin

Profile Details

NPI number 1679538011
LBN Legal business name Groteluschen, David L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Dec 20th, 2021 - about 5 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 1679538011 NPPES
Wisconsin MEDICAID 34871500
Wisconsin MEDICAID 104894036
Wisconsin Other DG088696

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