Healthcare Provider Details

I. General information

NPI: 1629513973
Provider Name (Legal Business Name): VERSTEHEN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2016
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 ONTARIO RD
GREEN BAY WI
54311-8302
US

IV. Provider business mailing address

4434 OAK RIDGE CIR
DE PERE WI
54115-9224
US

V. Phone/Fax

Practice location:
  • Phone: 920-983-9633
  • Fax:
Mailing address:
  • Phone: 920-983-9633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER M FISCHER
Title or Position: OWNER
Credential: MD
Phone: 920-983-9633