Individual
DR. JOSEPH EDGAR TRADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 N 10TH ST, MANITOWOC, WI 54220-4039
(920) 682-6376
(920) 682-6778
Mailing address
PO BOX 907, MANITOWOC, WI 54221-0907
(920) 682-6376
(920) 682-6778
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
18035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200010934
RAILROAD MEDICARE
WI
05
—
30171800
—
WI
Enumeration date
09/27/2006
Last updated
10/10/2011
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