Individual
MICHAEL POTHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8348 WASHINGTON AVE, MOUNT PLEASANT, WI 53406-3733
(262) 884-4000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
64751
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100049634
—
WI
Enumeration date
06/27/2012
Last updated
12/11/2024
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