DAVID EUGENE BERTLER (NPI# 1083657555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083657555 |
| Entity Type | Individual |
| Full Name | DAVID EUGENE BERTLER |
| Credential | M.D. |
| Practice Address |
1400 Scheuring Rd De Pere WI 54115-1067 |
| Mailing Address |
801 York St Manitowoc WI 54220-4630 |
| Practice Telephone | 9206835278 |
| Practice Fax Number | 9206832131 |
| Mailing Telephone | 9206639008 |
| Mailing Fax Number | 9206841439 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-02-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 29339020 | WI | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
29339020 | WI | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
29339020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32318400 | 05 | |
| WI | DEA | BB4957239 | 01 |
| WI | STATE LICENSE | 29339-020 | 01 |
| WI | RAILROAD MEDICARE | P00218264 | 01 |
| WI | MEDICARE | 382000019 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1007 Harbor Hills Dr Ste C, Marquette, MI 498558977 | 9062255458 | 9062251179 |
| 1610 Maxwell Dr Ste 210, Hudson, WI 540164004 | 7153865278 | 7153865508 |
| 2600 N Mayfair Rd Ste 810, Milwaukee, WI 532261328 | 4147711122 | 4147711352 |
| 2806 Riverview Dr, Green Bay, WI 543136717 | 9204987546 | 9205694129 |
| 3515 Murray St, Marinette, WI 541433367 | 7157320699 | 7157323522 |
| 3935 N Lightning Dr, Appleton, WI 549136717 | 9209681790 | 9209681794 |
| 510 N 17th Ave Ste C, Wausau, WI 544014281 | 7158495333 | 7158494083 |
| 715 Superior Rd Ste 120, Green Bay, WI 543117595 | 9204069803 | 9204069934 |
| Street Address |
1400 SCHEURING RD |
| City | DE PERE |
| State | WI |
| Zip Code | 54115-1067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376599324 | Michelle L Cihla | Dermatology | 1400 Scheuring Rd, De Pere, WI 54115-1067 | 2006-05-25 |
| 1124145040 | Lisa Lynne Butenhoff Campbell | Dermatology | 1400 Scheuring Rd, De Pere, WI 54115 | 2007-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871138073 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 723 Main Ave, Depere, WI 54115 | 2019-11-12 |
| 1568928083 | Stephanie J Towle | Speech-Language Pathologist | 200 S. 9th St, De Pere, WI 54115 | 2019-02-20 |
| 1164988499 | Maribel L Zoeller | Physical Therapy Assistant | 200 S. 9th Street, Depere, WI 54115 | 2019-02-12 |
| 1255897641 | Elizabeth Eberius | Acupuncturist | 3311 S. Packerland Drive, Suite A #20, De Pere, WI 54115 | 2019-02-11 |
| 1548750458 | Jordyn E Arndt | Physical Therapist | 1601 Lawrence Dr Ste 100, De Pere, WI 54115 | 2018-05-16 |
| 1588153514 | David Nowakowski | Registered Nurse | 158 Cavil Way, De Pere, WI 54115 | 2018-05-04 |
| 1457858557 | Rennes Assisted Living Corp. | Assisted Living Facility | 1150 Lois Street, Depere, WI 54115 | 2018-04-06 |
| 1518473966 | Kirsten Lynne Masrelian | Behavioral Analyst | 2073 Lawrence Dr, De Pere, WI 54115 | 2017-12-21 |
| 1285146050 | Sydney Marie Schultz | Physical Medicine & Rehabilitation | 200 S. Ninth Street, De Pere, WI 54115 | 2017-11-01 |
| 1134666514 | Nicole L Bickham | Psychologist | 416 George St Ste 108, De Pere, WI 54115 | 2017-01-24 |
| Find all providers in zip 54115 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588857247 | Forefront Dermatology, S.c. | Dermatology | 1400 Scheuring Road, De Pere, WI 54115 | 2007-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605880 | Forefront Dermatology Sc | Dermatology | W7713 Johnson Ct, Wautoma, WI 54982-5274 | 2020-10-05 |
| 1023482569 | Forefront Dermatology, S.c. | Dermatology | 1320 Pabst Farms Cir, Suite 180, Oconomowoc, WI 53066 | 2015-11-20 |
| 1417105545 | Forefront Dermatology, S.c. | Dermatology | 3515 Murray Street, Marinette, WI 54143 | 2008-09-03 |
| 1083768253 | Forefront Dermatology, S.c. | Dermatology | 3935 N Lightning Dr, Appleton, WI 54913 | 2007-01-23 |
| 1003356692 | Forefront Dermatology, S.c. | Dermatology | 17100 W North Ave, Suite 200, Brookfield, WI 53005 | 2017-03-01 |
| 1477001956 | Forefront Dermatology, S.c. | Dermatology | 8501 75th St, Suite J, Kenosha, WI 53142 | 2016-09-14 |
| 1215483201 | Forefront Dermatology, S.c. | Dermatology | 10500 W Loomis Rd, Suite 110, Franklin, WI 53132 | 2016-08-30 |
| 1275913006 | Maxim Alexandrovich Polansky | Dermatology | 1000 N Oak Ave, Marshfield, WI 54449-5703 | 2015-06-06 |
| 1013350958 | New Dermatology Group Ltd | Dermatology | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2013-04-10 |
| 1356784334 | New Dermatology Group Ltd | Dermatology | 1747 Shawano Ave, Green Bay, WI 54303-3243 | 2013-04-09 |
| 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.