Nystrom, Susan
Nystrom, Susan is an sole proprietor health care provider with primary practice located at 855 N Westhaven Dr , Oshkosh WI 54904-7668. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Nystrom, Susan can be contacted via phone (920) 303-8700.Contact Information
Primary practice address
855 N Westhaven Dr
Oshkosh WI 54904-7668
Phone: (920) 303-8700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 68879-21 | Wisconsin |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 5101017725 | Michigan |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 68879 | Wisconsin |
Profile Details
| NPI number | 1285894311 |
|---|---|
| LBN Legal business name | Nystrom, Susan |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2008 |
| Last updated | Mar 27th, 2024 - about last year |
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 | 1285894311 | NPPES |
| Wisconsin | MEDICAID | 100075784 |
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