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NPI Code Detail

MEDICARE: MATHIAS DAHNERT P.A.

MEDICARE: MATHIAS DAHNERT P.A.
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
1363A00000XPhysician Assistant3658-23WI
2363AM0700XMedical Physician Assistant3658-23WI
3363A00000XPhysician Assistant3658WI

General Provider Information

NPI Number : 1700253101
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATHIAS DAHNERT P.A.
Provider Business Mailing Address
First Line : 108 NOBLE CT
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-8936
Country : US
Telephone Number : 480-231-5700
Fax Number :
Provider Business Practice Location Address
First Line : 835 S VAN BUREN ST
Second Line :
City : GREEN BAY
State : WI
Zip : 54301-3575
Country : US
Telephone Number : 920-433-0111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2015
Last Update Date : 12/25/2021

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Directions to “ MATHIAS DAHNERT P.A.” Practice Location

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