Individual
ROBERT B DEVERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 WARREN ST, REDGRANITE, WI 54970-9391
(920) 566-0620
Mailing address
1810 HICKORY LN, OSHKOSH, WI 54901-2511
(920) 236-9126
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35193
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32003100
—
WI
Enumeration date
05/05/2006
Last updated
11/30/2021
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