Individual
JOSE C DIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3329 EXPRESS CT, APPLETON, WI 54915-3278
(920) 733-5900
Mailing address
3329 EXPRESS CT, APPLETON, WI 54915-3278
(920) 733-5900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39485
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32392800
—
WI
Enumeration date
09/08/2005
Last updated
11/27/2023
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