Search › Wisconsin › 183500000X
Mike Prodoehl
NPI 1750772547 · on the registry since 2015
Practice
- Address
- 760 W Johnson St
Fond Du Lac, WI 54935 - Phone
- (920) 929-7422
- Organisation at this address
- Roundys Supermarkets Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 7
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-02-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin