Detrana, Philip M.
Detrana, Philip M. is an sole proprietor health care provider with primary practice located at 2414 Kohler Memorial Dr , Sheboygan WI 53081-3129. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Detrana, Philip M. can be contacted via phone (920) 457-4461.Contact Information
Primary practice address
2414 Kohler Memorial Dr
Sheboygan WI 53081-3129
Phone: (920) 457-4461
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 36416 | Wisconsin |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 36416 | Wisconsin |
Profile Details
| NPI number | 1013992643 |
|---|---|
| LBN Legal business name | Detrana, Philip M. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 6th, 2005 |
| Last updated | Nov 30th, 2021 - about 3 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 | 1013992643 | NPPES |
| Wisconsin | MEDICAID | 32101500 |
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