Dedrick, David J
Dedrick, David J is an individual health care provider with primary practice located at 1506 S Oneida St , Appleton WI 54915-1305. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Dedrick, David J can be contacted via phone (920) 738-2000.Contact Information
Primary practice address
1506 S Oneida St
Appleton WI 54915-1305
Phone: (920) 738-2000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 38508-20 | Wisconsin |
Profile Details
| NPI number | 1154360931 |
|---|---|
| LBN Legal business name | Dedrick, David J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Nov 1st, 2022 - about 2 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 | 1154360931 | NPPES |
| Wisconsin | MEDICAID | 32496700 |
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