Individual
MICHAEL E BROUETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2825 HUNTERS TRL, PORTAGE, WI 53901-3429
(608) 742-7161
(608) 745-3990
Mailing address
2825 HUNTERS TRL, PORTAGE, WI 53901-3429
(608) 742-7161
(608) 745-3990
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1860023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437132669
—
WI
Enumeration date
11/22/2005
Last updated
11/04/2020
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