Groteluschen, David L
Groteluschen, David L is an individual health care provider with primary practice located at 1726 Shawano Ave , Green Bay WI 54303-3216. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Groteluschen, David L can be contacted via phone (920) 884-3135.Contact Information
Primary practice address
1726 Shawano Ave
Green Bay WI 54303-3216
Phone: (920) 884-3135
Fax: (920) 884-3144
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Medical Oncology | 207RX0202X | 44953 | Wisconsin |
Profile Details
| NPI number | 1679538011 |
|---|---|
| LBN Legal business name | Groteluschen, David L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 19th, 2006 |
| Last updated | Dec 20th, 2021 - about 4 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 | 1679538011 | NPPES |
| Wisconsin | MEDICAID | 34871500 | |
| Wisconsin | MEDICAID | 104894036 | |
| Wisconsin | Other | DG088696 |
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