Provider Demographics
NPI:1619116878
Name:ASCHE, DALE EDWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:EDWIN
Last Name:ASCHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 17TH ST
Mailing Address - Street 2:
Mailing Address - City:TWO RIVERS
Mailing Address - State:WI
Mailing Address - Zip Code:54241-3107
Mailing Address - Country:US
Mailing Address - Phone:920-242-7202
Mailing Address - Fax:
Practice Address - Street 1:900 17TH ST
Practice Address - Street 2:
Practice Address - City:TWO RIVERS
Practice Address - State:WI
Practice Address - Zip Code:54241-3107
Practice Address - Country:US
Practice Address - Phone:920-242-7202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI41205207R00000X
OH46934207R00000X
IL074890207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine