Donatelle, Lawrence R

Donatelle, Lawrence R is an individual health care provider with primary practice located at 878 Airport Rd , Menasha WI 54952-1461. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Donatelle, Lawrence R can be contacted via phone (920) 727-5982.

Contact Information

Primary practice address
878 Airport Rd Menasha WI 54952-1461
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 25239 Wisconsin

Profile Details

NPI number 1871587782
LBN Legal business name Donatelle, Lawrence R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2005
Last updated Sep 5th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871587782 NPPES
Wisconsin MEDICAID 30647300

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