Betancourt, Edgar
Betancourt, Edgar is an individual health care provider with primary practice located at 333 Pine Ridge Blvd , Wausau WI 54401-4120. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Betancourt, Edgar can be contacted via phone (715) 847-2130.Contact Information
Primary practice address
333 Pine Ridge Blvd
Wausau WI 54401-4120
Phone: (715) 847-2130
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 43096 | Wisconsin |
Profile Details
| NPI number | 1174593875 |
|---|---|
| LBN Legal business name | Betancourt, Edgar |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2006 |
| Last updated | Oct 18th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174593875 | NPPES |
| Wisconsin | MEDICAID | 34061700 |
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