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Individual

DAVID E RESEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8619 EDGEWATER RDG, OMRO, WI 54963-9760
(920) 376-1256
Mailing address
PO BOX 43, GREEN LAKE, WI 54941-0043
(920) 376-1255

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
32951
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33321900
WI
Enumeration date
05/23/2005
Last updated
12/11/2014
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