Raguse, Brian R

Raguse, Brian R is an individual health care provider with primary practice located at 1160 Kepler Dr , Green Bay WI 54311. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Raguse, Brian R can be contacted via phone (920) 288-5555.

Contact Information

Primary practice address
1160 Kepler Dr Green Bay WI 54311
Phone: (920) 288-5555
Fax: (920) 288-5550
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1663 Wisconsin

Profile Details

NPI number 1316959083
LBN Legal business name Raguse, Brian R
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated Sep 30th, 2008 - about 18 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 1316959083 NPPES
Wisconsin MEDICAID 41980900

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