Provider Demographics
NPI:1033225297
Name:PHILIP DURKEE, BINU MARIA (DO)
Entity Type:Individual
Prefix:DR
First Name:BINU
Middle Name:MARIA
Last Name:PHILIP DURKEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BINU
Other - Middle Name:MARIA
Other - Last Name:PHILIP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:3221 STEIN BLVD
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6930
Mailing Address - Country:US
Mailing Address - Phone:715-834-2788
Mailing Address - Fax:715-834-2845
Practice Address - Street 1:2741 N. CLAIREMONT AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-2595
Practice Address - Country:US
Practice Address - Phone:715-834-0711
Practice Address - Fax:715-858-3433
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI43521207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43509000Medicaid
WI43509000Medicaid
000980256Medicare ID - Type Unspecified