Individual
DR. RENE MARTIN EARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2221 S WEBSTER AVE, STE 241, GREEN BAY, WI 54301-2158
(920) 965-0345
(920) 273-6011
Mailing address
2221 S WEBSTER AVE, STE 241, GREEN BAY, WI 54301-2158
(920) 965-0345
(920) 273-6011
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
036044864
IL
207N00000X
Dermatology Physician
Primary
54674-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021606246
BCBS
IL
Enumeration date
11/09/2006
Last updated
12/21/2015
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