Organization
FOREFRONT DERMATOLOGY, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETSY J WERNLI MD (PRESIDENT)
(920) 482-0671
Entity
Organization
Contact information
Practice address
2351 STATE ROAD 44, OSHKOSH, WI 54904
(920) 651-8855
(920) 385-0287
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 683-5278
(920) 686-9674
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000038200
MEDICARE
WI
05
—
1073837563
—
WI
Enumeration date
03/26/2010
Last updated
05/16/2018
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