Individual
DALE T BERTRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 HONEY BEAR CT, WAUPACA, WI 54981-1071
(608) 516-9278
Mailing address
611 HONEY BEAR CT, WAUPACA, WI 54981-1071
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25540
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30688500
—
WI
Enumeration date
05/01/2006
Last updated
03/18/2013
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