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Individual

MS. AMY R DYSART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5300 MEMORIAL DR, TWO RIVERS, WI 54241-3923
(920) 793-6500
(920) 793-6501
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036-165653
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
43777
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
70033900
WI
Enumeration date
01/25/2007
Last updated
04/09/2026
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