MICHAEL R DEPEW (NPI# 1619032919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619032919 |
| Entity Type | Individual |
| Full Name | MICHAEL R DEPEW |
| Credential | PA |
| Practice Address |
1650 S. 41st St. Lakeshore Orthopedics Manitowoc WI 54220 |
| Practice Telephone | 9206825233 |
| Mailing Telephone | 9206825233 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2007-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1419 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41956200 | 05 |
| Street Address |
1650 S. 41ST ST. LAKESHORE ORTHOPEDICS |
| City | MANITOWOC |
| State | WI |
| Zip Code | 54220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235614843 | Katherine Borchardt | Registered Nurse | 3520 Foxfire Ct, Manitowoc, WI 54220 | 2018-09-28 |
| 1285128215 | Aurora Pharmacy Inc | Pharmacy | 3509 Dewey Street, Suite 100, Manitowoc, WI 54220 | 2018-06-22 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1831593821 | Brittany Camille Schultz | Acupuncturist | 2510 Washington Street, Manitowoc, WI 54220 | 2014-10-20 |
| 1710311261 | Brian E Weitz | Physical Therapy Assistant | 960 S. Rapids Rd., Manitowoc, WI 54220 | 2013-09-01 |
| 1134499080 | Total Renal Care Inc | Clinic/Center | 3303 Dewey St, Manitowoc, WI 54220 | 2012-01-10 |
| 1679858534 | Lisa M Noworatzky | Marriage & Family Therapist | 926 S. 8th St., Manitowoc, WI 54220 | 2011-10-11 |
| 1306177225 | Cynthia Fay Wenzel | Licensed Practical Nurse | 915 East Linden Avenue, Manitowoc, WI 54220 | 2010-01-15 |
| 1851550628 | Roundys Supermarkets Inc | Pharmacy | 3300 Calumet Ave, Manitowoc, WI 54220 | 2008-06-05 |
| 1851566079 | Jennifer C Mcwilliams | Registered Nurse | 1004 Nth 8th St., Manitowoc, WI 54220 | 2008-04-29 |
| Find all providers in zip 54220 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821612045 | Cassidy Renee Thomas | Physician Assistant | 1111 Delafield St Ste 209, Waukesha, WI 53188-3403 | 2020-06-03 |
| 1982056768 | Luke Harbers | Physician Assistant | 6226 Bankers Rd Ste 11, Mount Pleasant, WI 53403-9799 | 2016-07-06 |
| 1093085664 | Abraham David Pacheco | Physician Assistant | 3246 S 35th St, Milwaukee, WI 53215-4156 | 2012-01-12 |
| 1346577954 | Darren Rosser | Physician Assistant | 2931 S 108th St, West Allis, WI 53227-3519 | 2009-11-03 |
| 1033359401 | Matthew S. Bay | Physician Assistant | 1818 N. Meade St Suite 240 West, Fox Valley Surgical Associates, Appleton, WI 54911-3496 | 2009-02-25 |
| 1265657068 | Surgical and Rehab Services Inc | Physician Assistant | E4051 Steven Way, Spring Green, WI 53588-9271 | 2007-04-16 |
| 1992844385 | Jill Ann Schumacher | Physician Assistant | 2265 90th St, Eau Claire, WI 54703-0181 | 2007-02-05 |
| 1609915073 | Brian Felix Robinson | Physician Assistant | S725 Turner Valley Rd, Mondovi, WI 54755-8331 | 2007-02-05 |
| 1124176383 | William Henry Price | Physician Assistant | 4819 5th Ave, Unit 2, Kenosha, WI 53140-2924 | 2007-01-06 |
| 1235195835 | Angela M Clark | Physician Assistant | 2009 5th St, Monroe, WI 53566-1546 | 2006-04-22 |
| Find all providers with the same taxonomy | ||||
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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.