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Individual

DOUGLAS J CRONIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
705 S UNIVERSITY AVE, STE 510, BEAVER DAM, WI 53916-3081
(920) 887-3102
(920) 885-8788
Mailing address
705 S UNIVERSITY AVE, STE 510, BEAVER DAM, WI 53916-3081
(920) 887-3102
(920) 885-8788

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
81-023
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1001738
PHYSICIANS PLUS
WI
01
2055
DEAN HEALTH INSURANCE
WI
05
42905400
WI
Enumeration date
05/12/2006
Last updated
07/07/2009
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