William J Dierberg M.D.

NPI 1013910785 - Plastic Surgery - 208200000X

NPI Details
NPI 1013910785
Gender Male
Enumeration Date 05/24/2005
Last Updated 10/29/2010
Entity Type Individual
Active Over 11 years ago
Practice Location
704 S WEBSTER AVE
STE 401
GREEN BAY WI, 54301-3531, US
Phone (920) 432-7000
Fax (920) 432-7517
Business Location
704 S WEBSTER AVE
SUITE 401
GREEN BAY WI, 54301-3531, US
Phone (920) 432-7000
Fax (920) 432-7517
Toxanomy
Taxonomy Code 208200000X
License State Wisconsin
License Number 31110-020
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According to our database, Dr. William J Dierberg M.D. NPI is 1013910785, taxonomy code is 208200000X and license number is 31110-020, license state is located at Wisconsin. William J Dierberg M.D. physically located at 704 S Webster Ave, Green Bay WI, 54301-3531. NPI Number William J Dierberg M.D. has the Individual type.

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1013910785 NPI number is provided on an as is basis without warranty of any kind. 1013910785 is maintained by the National Plan & Provider Enumeration System. The contents of William J Dierberg M.D. are for informational purposes only.