Individual
MICHAEL J HODULIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 LAWRENCE DR, DE PERE, WI 54115-9108
(920) 983-3220
(920) 983-3226
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30409-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30409-20
WISCONSIN LICENSE
WI
Enumeration date
05/06/2006
Last updated
03/17/2018
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