Individual
ROBERT ELWOOD WAMPLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3860 MONROE RD, DE PERE, WI 54115-8399
(920) 496-4700
(920) 431-1950
Mailing address
PO BOX 19070, PREVEA HEALTH, GREEN BAY, WI 54307-9070
(920) 496-4700
(920) 431-1950
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
21100
WI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
21100-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30120500
—
WI
Enumeration date
07/12/2006
Last updated
08/21/2012
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