Individual
DANIEL P WOLBRINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01066886
IN
2085R0202X
Diagnostic Radiology Physician
39211
IA
2085R0202X
Diagnostic Radiology Physician
53517
MN
2085R0202X
Diagnostic Radiology Physician
Primary
55007
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000622043
ANTHEM BCBS
IN
05
—
200953850
—
IN
01
—
P00800400
RAILROAD MEDICARE
IN
Enumeration date
07/24/2008
Last updated
04/13/2018
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