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Individual

DR. LARRY L DUENK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1703 N TAYLOR DR, SHEBOYGAN, WI 53081-1933
(920) 457-4438
Mailing address
4425 N PORT WASHINGTON RD, GLENDALE, WI 53212-1082
(920) 457-4438

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
31301-020
WI
207Q00000X
Family Medicine Physician
Primary
31301-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31632000
WI
Enumeration date
04/25/2006
Last updated
12/12/2022
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