Izabela J Ditchen MD

NPI 1104800911 - Family Medicine - 207Q00000X

NPI Details
NPI 1104800911
Gender Female
Enumeration Date 12/05/2005
Last Updated 03/19/2014
Entity Type Individual
Active Over 11 years ago
Practice Location
2714 RIVERVIEW DR
GREEN BAY WI, 54313-6715, US
Phone (920) 430-4760
Fax
Business Location
2714 RIVERVIEW DR
GREEN BAY WI, 54313-6715, US
Phone (920) 430-4760
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Wisconsin
License Number 45158
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According to our database, Izabela J Ditchen MD NPI is 1104800911, taxonomy code is 207Q00000X and license number is 45158, license state is located at Wisconsin. Izabela J Ditchen MD physically located at 2714 Riverview Dr, Green Bay WI, 54313-6715. NPI Number Izabela J Ditchen MD has the Individual type.

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1104800911 NPI number is provided on an as is basis without warranty of any kind. 1104800911 is maintained by the National Plan & Provider Enumeration System. The contents of Izabela J Ditchen MD are for informational purposes only.