DR. FRED WALBRUN (NPI# 1306848700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306848700 |
| Entity Type | Individual |
| Full Name | DR. FRED WALBRUN |
| Credential | MD |
| Practice Address |
1715 Dousman St Green Bay WI 54303-3211 |
| Mailing Address |
Po Box 19070 Green Bay WI 54307-9070 |
| Practice Telephone | 9202721570 |
| Practice Fax Number | 9204311823 |
| Mailing Telephone | 9204964700 |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2016-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
22566 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
1715 DOUSMAN ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629071485 | Gayle M Kasdorf | Internal Medicine | 1715 Dousman St, Green Bay, WI 54303-3211 | 2005-05-24 |
| 1508476771 | Alea Meyer | Audiologist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2020-08-03 |
| 1003476276 | Jenna Mae Hanson | Physician Assistant | 1715 Dousman St, Green Bay, WI 54303-3211 | 2019-06-19 |
| 1932672409 | Kaylee Elizabeth Hoppe | Physician Assistant | 1715 Dousman St, Green Bay, WI 54303-3211 | 2019-01-08 |
| 1205307170 | Marjorie Hatszegi | Nurse Practitioner | 1715 Dousman St, Green Bay, WI 54303-3211 | 2018-12-17 |
| 1700362860 | Cassandra Jean Bedore | Audiologist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2018-07-12 |
| 1033632336 | Shilpa Mohan Ullikashi | Pediatrics | 1715 Dousman St, Green Bay, WI 54303-3211 | 2017-07-19 |
| 1811431372 | Lauryn Carlson | Registered Nurse | 1715 Dousman St, Green Bay, WI 54303-3211 | 2016-12-16 |
| 1831543529 | Rachael John | Occupational Therapist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2016-04-19 |
| 1780099911 | Anusha Surender | Internal Medicine | 1715 Dousman St, Green Bay, WI 54303-3211 | 2014-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487015301 | Louis Harvey Frase | Internal Medicine | 2516 E Princeton Ave, Eau Claire, WI 54703-4133 | 2016-03-20 |
| 1588045702 | Maureen Bruns | Internal Medicine | 3054 Maple Grove Dr, Madison, WI 53719-1912 | 2015-06-12 |
| 1952554966 | William Jerold Hisgen | Internal Medicine | 1215 Garfield St, 1215 Garfield St., Madison, WI 53711-2215 | 2008-11-04 |
| 1114005642 | Ahmet U. Demircioglu | Internal Medicine | 2000 E Layton Ave Ste 170, St Francis, WI 53235-6055 | 2006-11-01 |
| 1235229568 | Mary Parish Gavinski | Internal Medicine | 205 Bishops Way, Brookfield, WI 53005-6247 | 2006-10-16 |
| 1831200781 | In-your-home Medicine & Geriatrics | Internal Medicine | 3915 N Ridgefield Cir, Shorewood, WI 53211-2451 | 2006-08-31 |
| 1376653261 | Paul Joseph Drinkt | Internal Medicine | N2665 County Rd Qq, Wisconsin Veterans Home, King, WI 54946 | 2006-08-30 |
| 1003882994 | Soryal A Soryal | Internal Medicine | 1020 N 12th St, 3rd Floor, Milwaukee, WI 53233-1308 | 2006-02-28 |
| 1467439729 | Kanwardeep Singh | Internal Medicine | 1155 N Honey Creek Pkwy, Wauwatosa, WI 53213-3189 | 2005-12-28 |
| 1528674801 | Pai Participant 23 Sc | Internal Medicine | 1475 Birch Hill Ln, Shawano, WI 54166-3707 | 2020-09-22 |
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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.