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Individual

DR. ROBERT PERZACKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1820 APPLETON RD, MENASHA, WI 54952-1110
(920) 996-2200
(920) 996-2214
Mailing address
1820 APPLETON RD, MENASHA, WI 54952-1110
(920) 996-2200
(920) 996-2214

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
42925-020
WI
2084P0804X
Child & Adolescent Psychiatry Physician
47360
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043361
P1
MN
01
104348
UC
MN
05
1396761276
WI
01
15-55187
UBH
MN
05
378616100
MN
01
405L5PE
BCBS
MN
01
48630
HP
MN
Enumeration date
07/14/2006
Last updated
03/07/2023
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