Individual
MARC R. DURETTE
Active
Individual
MARC R. DURETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
28830
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
250006587
RAILROAD MEDICARE
WI
05
—
31572600
—
WI
Enumeration date
09/14/2006
Last updated
12/19/2012
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