Provider Demographics
NPI:1720182397
Name:NABER, MARTIN JOSEPH (OPA, SA-C)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:JOSEPH
Last Name:NABER
Suffix:
Gender:M
Credentials:OPA, SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 W RIVER WOODS PKWY
Mailing Address - Street 2:SUITE 305
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-1003
Mailing Address - Country:US
Mailing Address - Phone:414-961-2225
Mailing Address - Fax:414-961-0298
Practice Address - Street 1:575 W RIVER WOODS PKWY
Practice Address - Street 2:SUITE 305
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-1003
Practice Address - Country:US
Practice Address - Phone:414-961-2225
Practice Address - Fax:414-961-0298
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA161 NSOPACERTIFIED246ZS0410X
WI13-480 CERTIFICATE #246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist