AHMET DERVISH (NPI# 1104854462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104854462 |
| Entity Type | Individual |
| Full Name | AHMET DERVISH |
| Other Name | AHMET DERVISOGULLARI |
| Credential | MD |
| Practice Address |
2845 Greenbrier Rd Ste 340 Green Bay WI 54311-6519 |
| Mailing Address |
2845 Greenbrier Rd Ste 340 Po Box 8900 Green Bay WI 54308-8900 |
| Practice Telephone | 9202888380 |
| Practice Fax Number | 9202888385 |
| Mailing Telephone | 9202888380 |
| Mailing Fax Number | 9202888385 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2008-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
33794 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32021400 | 05 | |
| WI | RAILROAD | 050080452 | 01 |
| MI | 104365449 | 05 |
| Street Address |
2845 GREENBRIER RD STE 340 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54311-6519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033192943 | Timothy R Cooper | Anesthesiology | 2845 Greenbrier Rd Ste 340, Green Bay, WI 54311-6519 | 2005-11-23 |
| 1467615450 | Xinqian Chen | Physical Medicine & Rehabilitation | 2845 Greenbrier Rd Ste 340, Green Bay, WI 54311-6519 | 2008-07-09 |
| 1619905577 | Melissa S Marquart-carlson | Clinical Neuropsychologist | 2845 Greenbrier Rd Ste 340, Green Bay, WI 54311-6519 | 2006-06-29 |
| 1366470551 | Danzhu Guo | Physical Medicine & Rehabilitation | 2845 Greenbrier Rd Ste 340, Green Bay, WI 54311-6519 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295333847 | Karen Ginnow | Pharmacist | Walmart #1908, 2292 Main St, Green Bay, WI 54311 | 2020-10-15 |
| 1639786551 | Maggie Hall | Dental Hygienist | 2633 Development Dr. Ste 40, Green Bay, WI 54311 | 2020-09-24 |
| 1295370807 | Jennifer Marie Arendt | Technician | 2970 Mossy Oak Cir #39, Green Bay, WI 54311 | 2019-11-07 |
| 1518508803 | Cheryl Ann Johnson | Specialist | 830 Edgewood Dr., Green Bay, WI 54311 | 2019-10-08 |
| 1124670898 | Robert H Wagner Family Dentist S.c. | Dentist | 2830 Curry Court, Suite 1, Green Bay, WI 54311 | 2019-07-12 |
| 1821659624 | The Salvation Army | Counselor | The Salvation Army Ray & Joan Kroc Center, 1315 Lime Kiln Road, Green Bay, WI 54311 | 2019-06-24 |
| 1578052866 | Matthew Robert Wagner | Dentist | 2830 Curry Ln #1, Green Bay, WI 54311 | 2018-05-02 |
| 1861916769 | Atlas Spinal Care | Chiropractor | 2069 Central Ct, Suite 11, Green Bay, WI 54311 | 2017-08-01 |
| 1851844161 | Green Bay Family Dental LLC | Dentist | 2609 Development Dr., Green Bay, WI 54311 | 2016-08-03 |
| 1710382809 | Betsy Hoida | Pharmacist | 2485 Greenbrier Rd., Green Bay, WI 54311 | 2014-10-31 |
| Find all providers in zip 54311 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790309276 | Wisconsin Spine and Pain Sc | Pain Medicine | 1604 Cedar Bnd, Hartland, WI 53029-8663 | 2020-06-01 |
| 1679119689 | Pain Physicians of Wisconsin, Sc | Pain Medicine | 5007 S Howell Ave Ste 115, Milwaukee, WI 53207-6158 | 2019-11-25 |
| 1619359122 | Pain Relief, Inc. | Pain Medicine | 7520 Us Highway 51, Nwbj, Minocqua, WI 54548-8943 | 2015-06-19 |
| 1093001851 | Brian Curtin | Pain Medicine | 525 W River Woods Pkwy Ste 240, Glendale, WI 53212-1010 | 2011-06-21 |
| 1285924969 | Thomas J. Guhl, M.d., S.c. | Pain Medicine | 3305 S 20th St Ste 150, Milwaukee, WI 53215-4941 | 2011-04-14 |
| 1457459869 | Nichole Virgo | Pain Medicine | 8901 N 76th St Fl 3, Milwaukee, WI 53223-1901 | 2006-09-20 |
| 1740889021 | Midwest Interventional Pain and Diagnostics | Pain Medicine | 525 W River Woods Pkwy Ste 240, Glendale, WI 53212-1010 | 2020-10-19 |
| 1720499759 | Ryan William Clark | Pain Medicine | 12203 Corporate Pkwy, Mequon, WI 53092 | 2014-05-13 |
| 1750791901 | David L. Scherwinski, M.d., S.c. | Pain Medicine | 140 24th St S, Wisconsin Rapids, WI 54494-1906 | 2014-04-28 |
| 1275799264 | Alberto C Clar Md Sc | Pain Medicine | 8901 N 76th St, Milwaukee, WI 53223-1901 | 2008-07-30 |
| 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.