Individual
TYLER BERANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(902) 802-8426
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101021182
MI
207P00000X
Emergency Medicine Physician
Primary
74098
WI
207P00000X
Emergency Medicine Physician
R5360
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100110855
—
WI
Enumeration date
06/04/2014
Last updated
10/06/2023
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