Individual
MR. DEAN LOUIS MARTINELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
888 THACKERAY TRAIL, SUITE 108, OCONOMOWOC, WI 53066
(262) 567-0505
(262) 567-0778
Mailing address
888 THACKERAY TRAIL, SUITE 108, OCONOMOWOC, WI 53066
(262) 567-0505
(262) 567-0778
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
18169
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004202
PHYSICIANS PLUS
WI
05
—
30179100
—
WI
01
—
588
DEAN HEALTH PLAN
WI
Enumeration date
02/21/2006
Last updated
02/27/2008
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