Healthcare Provider Details

I. General information

NPI: 1992982987
Provider Name (Legal Business Name): WARREN DOERING R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 W COLLEGE AVE
APPLETON WI
54914-4644
US

IV. Provider business mailing address

2310 W COLLEGE AVE
APPLETON WI
54914-4644
US

V. Phone/Fax

Practice location:
  • Phone: 920-739-9232
  • Fax: 920-739-5813
Mailing address:
  • Phone: 920-739-9232
  • Fax: 920-739-5813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8808-040
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: