Organization
NORTHERN PINES EAR NOSE AND THROAT SC
Active
Organization
NORTHERN PINES EAR NOSE AND THROAT SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE LEE FACER DO (OTOLARYNGOLOGIST)
(715) 831-3300
Entity
Organization
Contact information
Practice address
4956 BULLIS FARM RD, EAU CLAIRE, WI 54701
(715) 831-3300
(715) 831-7958
Mailing address
4956 BULLIS FARM RD, EAU CLAIRE, WI 54701
(715) 831-3300
(715) 831-7958
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
44656
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102518
HEALTHPARTNERS
—
05
—
43498800
—
WI
01
—
DC0240
RR MEDICARE
—
Enumeration date
01/18/2007
Last updated
05/01/2008
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