Kevin L Mortara MD

NPI 1033109210 - Internal Medicine - 207RH0003X

NPI Details
NPI 1033109210
Gender Male
Enumeration Date 10/27/2005
Last Updated 06/12/2014
Entity Type Individual
Active Over 11 years ago
Practice Location
1580 COMMANCHE AVE
GREEN BAY WI, 54313-5751, US
Phone (920) 435-8326
Fax (920) 430-4659
Business Location
1580 COMMANCHE AVE
GREEN BAY WI, 54313-5751, US
Phone (920) 435-8326
Fax (920) 430-4659
Toxanomy
Taxonomy Code 207RH0003X
License State Wisconsin
License Number 48997-20
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According to our database, Dr. Kevin L Mortara MD NPI is 1033109210, taxonomy code is 207RH0003X and license number is 48997-20, license state is located at Wisconsin. Kevin L Mortara MD physically located at 1580 Commanche Ave, Green Bay WI, 54313-5751. NPI Number Kevin L Mortara MD has the Individual type.

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1033109210 NPI number is provided on an as is basis without warranty of any kind. 1033109210 is maintained by the National Plan & Provider Enumeration System. The contents of Kevin L Mortara MD are for informational purposes only.