Individual
DR. PHILIP M. DETRANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 457-4461
Mailing address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 457-4461
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
36416
WI
207RP1001X
Pulmonary Disease Physician
Primary
36416
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32101500
—
WI
Enumeration date
12/06/2005
Last updated
11/30/2021
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