Blegen, Cameron
Blegen, Cameron is an sole proprietor health care provider with primary practice located at 1475 W Grand Ave , Port Washington WI 53074-2074. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Blegen, Cameron can be contacted via phone (262) 268-5100.Contact Information
Primary practice address
1475 W Grand Ave
Port Washington WI 53074-2074
Phone: (262) 268-5100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 73170-20 | Wisconsin |
Profile Details
| NPI number | 1548791585 |
|---|---|
| LBN Legal business name | Blegen, Cameron |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 22nd, 2017 |
| Last updated | Nov 23rd, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548791585 | NPPES |
| Wisconsin | MEDICAID | 100092840 |
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