Gentine, Mary J
Gentine, Mary J is an individual health care provider with primary practice located at 1703 N Taylor Dr , Sheboygan WI 53081-1933. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Gentine, Mary J can be contacted via phone (920) 457-4438.Contact Information
Primary practice address
1703 N Taylor Dr
Sheboygan WI 53081-1933
Phone: (920) 457-4438
Fax: (920) 457-6748
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 40128-020 | Wisconsin |
Profile Details
| NPI number | 1811945942 |
|---|---|
| LBN Legal business name | Gentine, Mary J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Jun 12th, 2012 - about 12 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 | 1811945942 | NPPES |
| Wisconsin | MEDICAID | 33332800 |
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