Provider Demographics
NPI:1922166511
Name:NONN, ROBERT A (MD)
Entity Type:Individual
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First Name:ROBERT
Middle Name:A
Last Name:NONN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2500 E CAPITOL DRIVE
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911
Mailing Address - Country:US
Mailing Address - Phone:920-734-9600
Mailing Address - Fax:920-734-4773
Practice Address - Street 1:200 THEDA CLARK MEDICAL PLZ
Practice Address - Street 2:SUITE 480
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2721
Practice Address - Country:US
Practice Address - Phone:920-729-0608
Practice Address - Fax:920-729-2902
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2017-06-22
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Provider Licenses
StateLicense IDTaxonomies
WI39988-020207RC0200X, 207RP1001X
WI39988207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32440100Medicaid
WI32440100Medicaid
G71220Medicare UPIN