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Individual

MR. EDWARD J WASIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1910 ALABAMA ST, STURGEON BAY, WI 54235-3532
(920) 746-7200
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 746-7200

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704202513
MI
363L00000X
Nurse Practitioner
6719
WI
363LF0000X
Family Nurse Practitioner
Primary
6719
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0829560001
MEDICARE DME
MI
05
100051928
WI
01
EW202513
BCBS LICENSE NUMBER
MI
Enumeration date
10/02/2006
Last updated
11/17/2025
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