| NPI | 1083646608 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2006-07-06 |
| Last Updated | 2023-06-01 |
| Mailing Address | 3916 N Intertech Ct Appleton, WI 54913 United States Phone: (920) 996-1000 | Fax: (920) 997-8302 📍 View Map |
| Primary Practice Address | 3916 N Intertech Ct Appleton, WI 54913 United States Phone: (920) 996-1000 | Fax: (920) 997-8302 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | WI | 31480500 | — |
| Other (non-Medicare) | — | P00062904 | RR MEDICARE |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207R00000X – Internal Medicine | WI | 30115-020 |
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →
About NPI 1083646608
Stephen R Dernlan MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1083646608. The primary specialty listed is Internal Medicine. The provider is located in Appleton, WI. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-07-06. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1083646608?
NPI 1083646608 belongs to Stephen R Dernlan MD, a Internal Medicine in Appleton, WI. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1083646608 active?
The current status of NPI 1083646608 in the NPPES registry is Active. The record was last updated on 2023-06-01.
What specialty is NPI 1083646608?
NPI 1083646608 is classified under the taxonomy Internal Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1083646608?
You can verify NPI 1083646608 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1083646608?
The primary practice address on file for NPI 1083646608 is 3916 N Intertech Ct, Appleton, WI 54913. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1083646608 issued?
NPI 1083646608 was first issued (enumerated) on 2006-07-06. The NPPES record was last updated on 2023-06-01.
Practice Location Map
Stephen R Dernlan is located at 3916 N Intertech Ct, Appleton, WI. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Stephen R Dernlan. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1083646608. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Internal Medicine | 30115-020 | WI |