Individual
JAYDEN DER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 E CAPITOL DR, APPLETON, WI 54911-8728
(920) 831-5050
(920) 738-6507
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 831-5050
(920) 738-6507
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
4301098870
MI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
65587
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659659282
—
WI
Enumeration date
08/01/2011
Last updated
06/07/2023
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