Provider Demographics
NPI:1477562510
Name:CONGER, DAVID G (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:CONGER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3301 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2843
Mailing Address - Country:US
Mailing Address - Phone:414-647-6326
Mailing Address - Fax:414-671-8860
Practice Address - Street 1:1910 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:STURGEON BAY
Practice Address - State:WI
Practice Address - Zip Code:54235
Practice Address - Country:US
Practice Address - Phone:920-746-7200
Practice Address - Fax:920-746-7297
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
WI18800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31060400Medicaid
AC6186337OtherDEA NUMBER
B52170Medicare UPIN