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General NPI Number Information
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NPI Number | 1083657555
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Entity Type | Individual
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Provider Name | DAVID EUGENE BERTLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1400 SCHEURING RD
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City | DE PERE
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State | WI
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Zip | 54115-1067
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Country | US
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Telephone | 920-683-5278
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Fax | 920-683-2131
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Provider Business Mailing Address
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Address Line | 801 YORK ST
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City | MANITOWOC
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State | WI
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Zip | 54220-4630
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Country | US
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Telephone | 920-663-9008
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Fax | 920-684-1439
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 29339020
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 29339020
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 29339020
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License Number State | WI
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