Individual
LARRY M OJEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1905 E. HUEBBE PARKWAY, BELOIT HEALTH SYSTEM INC., BELOIT, WI 53511-1842
(608) 364-2200
(608) 364-2705
Mailing address
1905 E. HUEBBE PARKWAY, BELOIT HEALTH SYSTEM INC., BELOIT, WI 53511-1842
(608) 364-2200
(608) 364-2705
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
036-057903
IL
208800000X
Urology Physician
Primary
28270
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10655
DEAN HEALTH PLAN
—
05
—
1265541999
—
WI
Enumeration date
08/29/2006
Last updated
10/19/2011
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