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600 York St Suite 9 Manitowoc WI 54220-6845 | |
| (920) 320-6270 | |
| (920) 320-6729 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 600 York St, Manitowoc, Wisconsin |
| Authorized Official Name and Position | Jon Ring (VICE PRESIDENT PHYSICIAN SERVICES) |
| Authorized Official Contact | 9203208427 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2290 Manitowoc WI 54221-2290 Ph: (920) 320-8740 | 600 York St Suite 9 Manitowoc WI 54220-6845 Ph: (920) 320-6270 |
| NPI Number | 1720175656 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 10/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720175656 | NPI | - | NPPES |
| 31792200 | Medicaid | WI | |
| 290423694006 | Other | WI | BCBS OF WISCONSIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
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