| Mercy Family Practice Service Corporation | |
|
1500 Heritage Rd, Suite A De Pere WI 54115-4017 | |
| (920) 347-1990 | |
| (920) 347-1991 |
| Full Name | Mercy Family Practice Service Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 1500 Heritage Rd, Suite A, De Pere, Wisconsin |
| Authorized Official Name and Position | Kevin P Rosteing (BUSINESS MANAGER) |
| Authorized Official Contact | 9203471990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Family Practice Service Corporation 1500 Heritage Rd, Suite A De Pere WI 54115-4017 Ph: (920) 347-1990 | Mercy Family Practice Service Corporation 1500 Heritage Rd, Suite A De Pere WI 54115-4017 Ph: (920) 347-1990 |
| NPI Number | 1831256866 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 03/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831256866 | NPI | - | NPPES |
| 34129300 | Medicaid | WI | |
| 000007335 | Other | WI | MEDICARE ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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