Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 60666 | WI |
N | 207VX0000X | Obstetrician | 4301054854 | MI |
NPI | 1114072931 |
---|---|
Provider Name | Mr. Jeffrey G Dinges |
First Address | Monroe, WI 53566-1569 |
Second Address | Monroe, WI 53566-1569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 28/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2928734 | (05) | MI |
F38611 | (02) | MI |