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NPI Code Detail

MEDICARE: MICHAEL S OLDENBURG MD

MEDICARE: MICHAEL S OLDENBURG 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
1207Y00000XOtolaryngology Physician56672MN
2207Y00000XOtolaryngology Physician67254-20WI

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 : 1770847683
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL S OLDENBURG MD
Provider Business Mailing Address
First Line : PO BOX 19070
Second Line :
City : GREEN BAY
State : WI
Zip : 54307-9070
Country : US
Telephone Number : 920-496-4700
Fax Number :
Provider Business Practice Location Address
First Line : 1860 SHAWANO AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54303-2667
Country : US
Telephone Number : 920-496-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2012
Last Update Date : 02/05/2024

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Directions to “ MICHAEL S OLDENBURG MD” Practice Location

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