Healthcare Provider Details

I. General information

NPI: 1720034515
Provider Name (Legal Business Name): JAMES R. WARPINSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 S MONROE AVE
GREEN BAY WI
54301-4017
US

IV. Provider business mailing address

PO BOX 22487
GREEN BAY WI
54305-2487
US

V. Phone/Fax

Practice location:
  • Phone: 920-435-6601
  • Fax: 920-436-3840
Mailing address:
  • Phone: 920-445-7226
  • Fax: 920-445-7289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number26194020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: