DR. WILLIAM J DIERBERG (NPI# 1013910785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013910785 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM J DIERBERG |
| Credential | M.D. |
| Practice Address |
704 S Webster Ave Ste 401 Green Bay WI 54301-3531 |
| Mailing Address |
704 S Webster Ave Suite 401 Green Bay WI 54301-3531 |
| Practice Telephone | 9204327000 |
| Practice Fax Number | 9204327517 |
| Mailing Telephone | 9204327000 |
| Mailing Fax Number | 9204327517 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2010-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | 31110-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31812800 | 05 | |
| DEA | BD2474500 | 01 | |
| WI | MEDICAL LICENSE | 31110-020 | 01 |
| Street Address |
704 S WEBSTER AVE STE 401 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-3531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932102787 | Pamela C Baeten | Internal Medicine | 704 S Webster Ave, Ste 500, Green Bay, WI 54301-3528 | 2005-05-24 |
| 1164959680 | Cynthia L Suplinski | Nurse Practitioner | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2017-05-15 |
| 1073063681 | Bellin Memorial Hospital Inc | Internal Medicine | 704 S Webster Ave, Suite 501, Green Bay, WI 54301-3528 | 2016-10-06 |
| 1265986731 | Susan Molenaar | Nurse Practitioner | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2016-08-12 |
| 1225403157 | Bonnie L Dejardin | Nurse Practitioner | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2015-12-03 |
| 1437531720 | Bellin Memorial Hospital Inc | Obstetrics & Gynecology | 704 S Webster Ave, Suite 100 A, Green Bay, WI 54301-3533 | 2015-06-23 |
| 1841672516 | Bellin Memorial Hospital Inc | Obstetrics & Gynecology | 704 S Webster Ave, Suite 100 B, Green Bay, WI 54301-3533 | 2015-06-18 |
| 1407295389 | Michael Chistopher Popelars | Dentist | 704 S Webster Ave, Suite 402, Green Bay, WI 54301-3528 | 2013-06-24 |
| 1013350958 | New Dermatology Group Ltd | Dermatology | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2013-04-10 |
| 1235444225 | Melissa A Anderson | Nurse Practitioner | 704 S Webster Ave, Suite 300, Green Bay, WI 54301-3528 | 2010-08-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
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| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831116797 | Steven C Schmidt | Plastic Surgery | 2605 Development Dr, Green Bay, WI 54311-4240 | 2006-07-16 |
| 1588170716 | Baycare Clinic, LLP | Plastic Surgery | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2017-12-26 |
| 1851411854 | Elizabeth A O'connor | Plastic Surgery | 2605 Development Dr, Green Bay, WI 54311-4240 | 2007-03-31 |
| 1932120573 | James M Zasuly | Plastic Surgery | 2605 Development Dr, Green Bay, WI 54311-4240 | 2006-07-21 |
| 1245204759 | James Lee | Plastic Surgery | 704 S Webster Ave, Ste 401, Green Bay, WI 54301-3528 | 2006-02-14 |
| 1932102613 | Eugene H Schmitt IIi | Plastic Surgery | 704 S Webster Ave, Ste 401, Green Bay, WI 54301-3531 | 2005-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1508122938 | Stephanie Suprenant | Plastic Surgery | Uw Hospital and Clinics 600 Highland Ave, H4/831, Madison, WI 53792-0001 | 2012-04-10 |
| 1770862054 | Alex Colque, M.d. S.c. | Plastic Surgery | 21675 E Moreland Blvd, Suite 100, Waukesha, WI 53186 | 2011-08-04 |
| 1114198660 | Ruedi Peter Gingrass | Plastic Surgery | 7130 Wellauer Dr, Wauwatosa, WI 53213-3767 | 2008-03-12 |
| 1669695284 | Fox Valley Plastic Surgery, S.c. | Plastic Surgery | 2400 Witzel Ave, Suite A, Oshkosh, WI 54904-8369 | 2007-04-11 |
| 1528105897 | Alex Colque | Plastic Surgery | 21675 E. Moreland Blvd., Suite 100, Waukesha, WI 53186-2906 | 2007-01-30 |
| 1447313747 | Kevin M. Robertson | Plastic Surgery | 3205 Glacier Ridge Rd, Middleton, WI 53562-1765 | 2006-12-18 |
| 1568532521 | Maida Ann Parkins | Plastic Surgery | W307 N1497 Golf Rd, Suite 200, Delafield, WI 53018 | 2006-11-08 |
| 1720183130 | Michelle R Bonness | Plastic Surgery | 20320 W Greenfield Ave, Brookfield, WI 53045-3737 | 2006-09-13 |
| 1154375996 | Roger C Mixter | Plastic Surgery | 5201 N Port Washington Rd, Milwaukee, WI 53217-4902 | 2006-05-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.