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Michael R Depew, PA
Surgical Physician Assistant in Manitowoc, Wisconsin
NPI 1619032919

Michael R Depew is a Surgical Physician Assistant based in Manitowoc, WI and is specialized in Surgical. Michael R Depew practices in Manitowoc, WI and has the professional credentials of PA. The NPI Number for Michael R Depew is 1619032919 and holds a License No. 1419 (Wisconsin).

The current practice location address for Michael R Depew is 1650 S. 41St St., Manitowoc, WI and can be reached out via phone at 920-682-5233.

Location: 1650 S. 41St St., Manitowoc, WI, 54220
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619032919
Provider Name
Michael R Depew
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
1650 S. 41St St., Manitowoc, WI, 54220
Phone Number
920-682-5233
Fax Number
Provider Enumeration Date
12/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
41956200 05 WI
institution
Provider Business Practice Location Address Details
Address
1650 S. 41St St.
City
Manitowoc
State
Wisconsin
Zip
54220
Phone Number
920-682-5233
Fax Number
person
Provider Business Mailing Address Details
Address
1650 S. 41St St.
City
Manitowoc
State
Wisconsin
Zip
54220
Phone Number
920-682-5233
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
363AS0400X
License No.
1419 (Wisconsin)
Definition
Definition to come...
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