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Individual

DR. PATRICK R MARSHO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1703 N TAYLOR DRIVE, SHEBOYGAN, WI 53081-1933
(920) 457-4438
(920) 457-6748
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(920) 457-4438
(920) 457-6748

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21502
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30248000
WI
Enumeration date
04/21/2006
Last updated
06/11/2012
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