MEDICARE: VERSTEHEN, LLC

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
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1629513973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERSTEHEN, LLC

Provider Business Mailing Address
First Line	:	4434 OAK RIDGE CIR
Second Line	:
City	:	DE PERE
State	:	WI
Zip	:	54115-9224
Country	:	US
Telephone Number	:	920-983-9633
Fax Number	:

Provider Business Practice Location Address
First Line	:	1351 ONTARIO RD
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54311-8302
Country	:	US
Telephone Number	:	920-983-9633
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PETER M FISCHER
Credential	:	MD
Telephone Number	:	920-983-9633

Provider Enumeration Date	:	12/22/2016
Last Update Date	:	12/22/2016

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Directions to “VERSTEHEN, LLC ” Practice Location

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