Organization
PENINSULA PODIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY GERARD BURKART DPM (MANAGING PARTNER)
(920) 743-6668
Entity
Organization
Contact information
Practice address
BLDG 4 2, 30 NORTH 18TH AVENUE, STURGEON BAY, WI 54235-3207
(920) 743-6668
(920) 743-9222
Mailing address
BLDG 4 2, 30 NORTH 18TH AVENUE, STURGEON BAY, WI 54235-3207
(920) 743-6668
(920) 743-9222
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
WI
332B00000X
Durable Medical Equipment & Medical Supplies
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43267300
—
WI
Enumeration date
10/03/2006
Last updated
02/05/2008
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