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Individual

DR. WILLIAM J DIERBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2605 DEVELOPMENT DR, GREEN BAY, WI 54311-4240
(920) 288-8240
Mailing address
2073 WINTERGREEN CT, GREEN BAY, WI 54304-1946
(920) 366-9814

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
31110-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31110-020
MEDICAL LICENSE
WI
05
31812800
WI
Enumeration date
05/24/2005
Last updated
03/07/2023
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