Individual
PAULA M HAVISTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
2251 N SHORE DR, RHINELANDER, WI 54501-6710
(715) 361-4700
Mailing address
2251 N SHORE DR, RHINELANDER, WI 54501-6710
(715) 361-4700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1773-023
WI
363A00000X
Physician Assistant
5601005426
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41997100
—
WI
Enumeration date
08/18/2005
Last updated
03/04/2015
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