Dr Robert W White Jr, MD | |
1520 S 41st St, Manitowoc, WI 54220-7312 | |
(920) 320-4660 | |
Not Available |
Full Name | Dr Robert W White Jr |
---|---|
Gender | Male |
Speciality | Preventive Medicine - Public Health & General Preventive Medicine |
Location | 1520 S 41st St, Manitowoc, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336308907 | NPI | - | NPPES |
28777841 | Medicaid | NM | |
51305879 | Medicaid | NM | |
53938577 | Medicaid | NM | |
94939063 | Medicaid | NM | |
01786342 | Medicaid | NM | |
46650024 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2083P0901X | Preventive Medicine - Public Health & General Preventive Medicine | 39073 (Colorado) | Primary |
Entity Name | Froedtert &the Medical College Of Wisconsin Community Physicians Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568787448 PECOS PAC ID: 3678760063 Enrollment ID: O20101210000699 |
Mailing Address | Practice Location Address |
---|---|
Dr Robert W White Jr, MD 3714 N 50th St, Sheboygan, WI 53083-2597 Ph: (803) 414-5189 | Dr Robert W White Jr, MD 1520 S 41st St, Manitowoc, WI 54220-7312 Ph: (920) 320-4660 |
Brian K Konowalchuk, Preventive Medicine Medicare: Medicare Enrolled Practice Location: 3509 Dewey St, Manitowoc, WI 54220 Phone: 920-686-5732 | |
Dennis B Phillips, DO Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 601 Reed Ave, Manitowoc, WI 54220 Phone: 920-793-7300 |