Individual
DR. TODD L. HOSTETLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
512 S 28TH AVE, WAUSAU, WI 54401-4147
(715) 847-2021
(715) 847-2325
Mailing address
512 S 28TH AVE, WAUSAU, WI 54401-4147
(715) 847-2021
(715) 847-2325
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
57120-20
WI
207R00000X
Internal Medicine Physician
57120-20
WI
208000000X
Pediatrics Physician
57120-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2755102
—
OH
Enumeration date
02/01/2007
Last updated
04/09/2020
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