Provider Demographics
NPI:1013965615
Name:VOGEL, EDWARD G (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:G
Last Name:VOGEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 5277
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-5277
Mailing Address - Country:US
Mailing Address - Phone:920-338-6868
Mailing Address - Fax:920-338-6869
Practice Address - Street 1:2641 DEVELOPMENT DR
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-4240
Practice Address - Country:US
Practice Address - Phone:920-338-6868
Practice Address - Fax:920-338-6869
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI17938207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology