MARK W DE CLUTE (NPI# 1417057142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417057142 |
| Entity Type | Individual |
| Full Name | MARK W DE CLUTE |
| Credential | MD |
| Practice Address |
2727 Plaza Drive Wausau WI 54401 |
| Mailing Address |
1000 N Oak Ave Marshfield WI 54449-5777 |
| Practice Telephone | 7158473000 |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
36415 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32110100 | 05 |
| Street Address |
2727 PLAZA DRIVE |
| City | WAUSAU |
| State | WI |
| Zip Code | 54401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982712204 | Mark A Huftel | Allergy & Immunology | 2727 Plaza Drive, Wausau, WI 54401 | 2006-08-27 |
| 1265527543 | David K Aughenbaugh | Internal Medicine | 2727 Plaza Drive, Wausau, WI 54401 | 2006-10-04 |
| 1689769960 | Mark A Richetto | Internal Medicine | 2727 Plaza Drive, Wausau, WI 54401 | 2006-10-04 |
| 1003901372 | Dale B Anderson | Internal Medicine | 2727 Plaza Drive, Wausau, WI 54401 | 2006-10-04 |
| 1407949886 | Catherine E Ortscheid | Nurse Practitioner | 2727 Plaza Drive, Wausau, WI 54401 | 2006-09-30 |
| 1255431631 | William K Dernbach | Internal Medicine | 2727 Plaza Drive, Wausau, WI 54401 | 2006-09-25 |
| 1508966235 | William A Bowler | Internal Medicine | 2727 Plaza Drive, Wausau, WI 54401 | 2006-09-23 |
| 1184722928 | Earl W Zabel | Obstetrics & Gynecology | 2727 Plaza Drive, Wausau, WI 54401 | 2006-09-20 |
| 1700984556 | Samir L Abadeer | Obstetrics & Gynecology | 2727 Plaza Drive, Wausau, WI 54401 | 2006-09-20 |
| 1902901580 | Randy J Stank | Nurse Anesthetist, Certified Registered | 2727 Plaza Drive, Wausau, WI 54401 | 2006-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1336701895 | Amy Kluetz | Counselor | 3000 Westhill Drive, Suite 100, Wausau, WI 54401 | 2019-07-05 |
| 1437640877 | Joseph T Fitz | Student in an Organized Health Care Education/Training Program | Aspirus Wausau Family Medicine, 425 Wind Ridge Drive, Wausau, WI 54401 | 2018-05-22 |
| 1699293241 | Amanda Nedd | Dietitian, Registered | 425 Pine Ridge Boulevard Suite 220 C, Wausau, WI 54401 | 2017-09-05 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1013389618 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 2727 Plaza Dr., Wausau, WI 54401 | 2015-10-22 |
| 1881091163 | Judy Lao | Dental Hygienist | 413 North 17th Avenue, Wausau, WI 54401 | 2014-12-02 |
| 1295012011 | Allison Waraksa | Pharmacist | 504 S. 17th Ave, Wausau, WI 54401 | 2011-11-08 |
| 1881974053 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 504 S 17th Ave, Wausau, WI 54401 | 2011-08-19 |
| Find all providers in zip 54401 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114152493 | Jacob H. Martens | Radiology | 414 Kent St, Wausau, WI 54403-6927 | 2009-05-15 |
| 1376555839 | Stephen B Stine | Radiology | 3200 Westhill Dr Ste 210, Wausau, WI 54401-4707 | 2006-08-13 |
| 1750700688 | Endel Aleksander Sorra II | Radiology | 333 Pine Ridge Blvd, Aspirus Hospital, Wausau, WI 54401 | 2014-04-08 |
| 1780014407 | Aspirus Wausau Hospital, Inc | Radiology | 3200 Westhill Dr, Wausau, WI 54401-4705 | 2013-11-15 |
| 1063674224 | Derrick Robson Siebert | Radiology | 333 Pine Ridge Blvd, Wausau, WI 54401-4120 | 2008-06-30 |
| 1952490054 | Aspirus Inc | Radiology | 3200 Westhill Dr, Wausau, WI 54401-4705 | 2006-10-12 |
| 1306946025 | Rosita S Go | Radiology | 2727 Plaza Dr, Wausau, WI 54401-4129 | 2006-09-23 |
| 1922118512 | Alan C Williams | Radiology | 2727 Plaza Drive, Wausau, WI 54401 | 2006-08-30 |
| 1255343703 | Vinay D Luthra | Radiology | 3200 Westhill Dr Ste 210, Wausau, WI 54401-4707 | 2006-08-13 |
| 1992714810 | John R Sorenson | Radiology | 3200 Westhill Dr, Suite 210, Wausau, WI 54401-4705 | 2006-08-07 |
| Find all providers in WAUSAU | ||||
Please comment or provide details below to improve the information on MARK W DE CLUTE.
| 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.