Individual
IRA S KASTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
237 W SEWARD ST, POYNETTE, WI 53955-9584
(608) 635-4343
(608) 635-7094
Mailing address
PO BOX 97, POYNETTE, WI 53955-0097
(608) 635-4343
(608) 635-7094
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20342-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000578
PHYSICIANS PLUS
WI
01
—
202
DEAN HEALTH INSURANCE
WI
05
—
30295300
—
WI
Enumeration date
05/11/2006
Last updated
05/06/2014
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