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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