Individual
DR. DAVID J DEDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2000
Mailing address
2323 N LAKE DR, MILWAUKEE, WI 53211-4508
(414) 961-5362
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
38508-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32496700
—
WI
Enumeration date
06/06/2006
Last updated
11/01/2022
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