NPI 1417947540

Rustan J Wiersma, MD

Practitioner Otolaryngology Physician Onalaska, WI

Practice location

Address: 191 Theatre Rd, Onalaska, WI 54650-8679
Phone: (608) 392-5000

Registered specialties

Otolaryngology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Y00000X Licence 23302 (WI)

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Registry record

NPI: 1417947540
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Oct 2005
Record last updated: 2 Apr 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.