Stover, Paul Michael

Stover, Paul Michael is an individual health care provider with primary practice located at 2806 Riverview Dr , Green Bay WI 54313-6717. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Stover, Paul Michael can be contacted via phone (920) 498-7546.

Contact Information

Primary practice address
2806 Riverview Dr Green Bay WI 54313-6717
Fax: (920) 569-4129
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 38944-020 Wisconsin

Profile Details

NPI number 1548264336
LBN Legal business name Stover, Paul Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Mar 7th, 2023 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548264336 NPPES
Wisconsin Other 000817140 MEDICARE
Wisconsin MEDICAID 1548264336 MEDICARE
Wisconsin Other P00338098 MEDICARE
Wisconsin Other 38944-020 MEDICARE

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