Individual
DIANA MARIA LOPATEGUI MINAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1821 S WEBSTER AVE, GREEN BAY, WI 54301-2253
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
83054-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100284785
—
WI
Enumeration date
07/18/2018
Last updated
12/18/2024
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