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General NPI Number Information
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NPI Number | 1578779914
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Entity Type | Organization
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Legal Business Name | DANA R. TROTTER MD SC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 5439 DURAND AVE #103
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City | RACINE
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State | WI
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Zip | 53406-5058
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Country | US
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Telephone | 262-637-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 5439 DURAND AVE SUITE # 103
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City | RACINE
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State | WI
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Zip | 53406-5058
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Country | US
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Telephone | 262-637-1000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANA R. TROTTER
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Credential | MD
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Telephone | 262-637-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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