Individual
RODERICK LANDON HUBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3916 N INTERTECH CT, APPLETON, WI 54913-6957
(920) 996-1000
(920) 996-1054
Mailing address
3916 N INTERTECH CT, APPLETON, WI 54913-6957
(920) 996-1000
(920) 996-1054
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
22625
NE
207R00000X
Internal Medicine Physician
4301089219
MI
207R00000X
Internal Medicine Physician
Primary
63905-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5200096
—
MI
Enumeration date
01/11/2007
Last updated
05/27/2015
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