Individual
LAURA B VAN WHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8722
(920) 926-8912
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8722
(920) 926-8912
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
43007
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34053500
—
WI
01
—
P00479349
RR MEDICARE
WI
Enumeration date
07/09/2006
Last updated
11/28/2023
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