Individual
NICHOLAS G STEPHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5000 MEMORIAL DR, TWO RIVERS, WI 54241-3900
(920) 794-5000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
47002
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34551900
—
WI
Enumeration date
03/24/2006
Last updated
03/28/2025
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