Earles, Rene Martin

Earles, Rene Martin is an individual health care provider with primary practice located at 2221 S Webster Ave Ste 241, Green Bay WI 54301-2158. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Earles, Rene Martin can be contacted via phone (920) 965-0345.

Contact Information

Primary practice address
2221 S Webster Ave Ste 241 Green Bay WI 54301-2158
Phone: (920) 965-0345
Fax: (920) 273-6011
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 036044864 Illinois
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 54674-20 Wisconsin

Profile Details

NPI number 1609946292
LBN Legal business name Earles, Rene Martin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2006
Last updated Dec 21st, 2015 - about 9 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 1609946292 NPPES
Illinois Other 0021606246 BCBS

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