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Individual

MICHAEL S OLDENBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1860 SHAWANO AVE, GREEN BAY, WI 54303-2667
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
56672
MN
207Y00000X
Otolaryngology Physician
Primary
67254-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100037584
WI
Enumeration date
06/26/2012
Last updated
02/05/2024
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