MEDICARE: THE CARING DOCTOR, 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	207Q00000X	Family Medicine Physician	38713-020	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1710966288	OTHER	WI	GENADI MALTINSKI

General Provider Information

NPI Number	:	1962622522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CARING DOCTOR, LLC

Provider Business Mailing Address
First Line	:	PO BOX 134
Second Line	:
City	:	KRAKOW
State	:	WI
Zip	:	54137-0134
Country	:	US
Telephone Number	:	920-855-2823
Fax Number	:	920-855-6343

Provider Business Practice Location Address
First Line	:	340 N GREEN BAY AVE
Second Line	:
City	:	GILLETT
State	:	WI
Zip	:	54124-9325
Country	:	US
Telephone Number	:	920-855-2823
Fax Number	:	920-855-6343

Authorized Official
Title or Position	:	CEO
Name	:	GENADI MALTINSKI
Credential	:	M.D.
Telephone Number	:	920-855-2823

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	09/11/2008

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Directions to “THE CARING DOCTOR, LLC ” Practice Location

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