Van Bommel, Jesse

Van Bommel, Jesse is an individual health care provider with primary practice located at 13760 W Capitol Dr , Brookfield WI 53005-2407. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Van Bommel, Jesse can be contacted via phone (262) 794-3140.

Contact Information

Primary practice address
13760 W Capitol Dr Brookfield WI 53005-2407
Phone: (262) 794-3140
Fax: (262) 794-3180
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 41512 Wisconsin

Profile Details

NPI number 1528012432
LBN Legal business name Van Bommel, Jesse
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Apr 12th, 2016 - about 10 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 1528012432 NPPES
Wisconsin MEDICAID 34231300
Wisconsin Other 007000261J

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