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NPI Code Detail

MEDICARE: DR. PAUL C UTRIE MD

MEDICARE: DR. PAUL C UTRIE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RR0500XRheumatology Physician38895WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326065368
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL C UTRIE MD
Provider Business Mailing Address
First Line : 2223 LIME KILN RD
Second Line : SUITE 1
City : GREEN BAY
State : WI
Zip : 54311-6213
Country : US
Telephone Number : 920-430-8120
Fax Number : 920-430-8122
Provider Business Practice Location Address
First Line : 2223 LIME KILN RD
Second Line : SUITE 1
City : GREEN BAY
State : WI
Zip : 54311-6213
Country : US
Telephone Number : 920-430-8120
Fax Number : 920-430-8122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2006
Last Update Date : 04/26/2022

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Directions to “ DR. PAUL C UTRIE MD” Practice Location

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