Individual
PAUL MICHAEL STOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2806 RIVERVIEW DR, GREEN BAY, WI 54313-6717
(920) 498-7546
(920) 569-4129
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 683-5278
(920) 686-9674
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
38944-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000817140
MEDICARE
WI
05
—
1548264336
—
WI
01
—
38944-020
STATE LICENSE
WI
01
—
P00338098
RAILROAD MEDICARE
WI
Enumeration date
06/09/2005
Last updated
03/07/2023
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