Individual
RICHARD POIRIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2253 W MASON ST, GREEN BAY, WI 54303-4706
(920) 327-7300
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 327-7300
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
1689
NE
207R00000X
Internal Medicine Physician
Primary
81125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100242305
—
WI
Enumeration date
02/10/2016
Last updated
07/17/2023
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