Individual
DR. DIANE THALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
33 GREEN BAY RD, STURGEON BAY, WI 54235-2831
(920) 683-5278
(920) 686-9674
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 683-5278
(920) 686-9674
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
23517020
WI
207N00000X
Dermatology Physician
Primary
23517020
WI
Other
Enumeration date
04/03/2006
Last updated
02/24/2021
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