Healthcare Provider Details

I. General information

NPI: 1417150863
Provider Name (Legal Business Name): PAUL B DUSCHER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 2ND ST
NEENAH WI
54956-2883
US

IV. Provider business mailing address

200 E. WASHINGTON ST. PO BOX 8031
APPLETON WI
54912-8031
US

V. Phone/Fax

Practice location:
  • Phone: 920-729-2063
  • Fax:
Mailing address:
  • Phone: 866-313-0337
  • Fax: 920-739-0124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number125-051708
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number52945-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: