NPI 1790720100 · live from the CMS NPI Registry
Dianna L Bordewick, MD
Ophthalmology in Green Bay, WI. National Provider Identifier 1790720100, active.
NPI record
| NPI | 1790720100 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology 207W00000X |
| Practice location | 2253 W Mason St Ste 100, Green Bay, WI 54303 |
| Practice phone | 920-327-7000 |
| Mailing address | 2253 W Mason St Ste 100, Po Box 13097, Green Bay, WI 54307 |
| Enumerated | June 19, 2006 |
| Last updated | August 28, 2008 |
| Sole proprietor | No |
| Other names | Dianna Myers |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology primary | 207W00000X | 41090 (WI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.