Individual
DR. KEVIN L MORTARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1580 COMMANCHE AVE, GREEN BAY, WI 54313-5751
(920) 435-8326
(920) 430-4659
Mailing address
1580 COMMANCHE AVE, GREEN BAY, WI 54313-5751
(920) 435-8326
(920) 430-4659
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
48997-20
WI
Other
Enumeration date
10/27/2005
Last updated
06/12/2014
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