Provider Demographics
NPI:1871596627
Name:PALUBIAK, DAVID J (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:PALUBIAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2020 RIVERSIDE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-2300
Mailing Address - Country:US
Mailing Address - Phone:920-433-9920
Mailing Address - Fax:920-433-9927
Practice Address - Street 1:2020 RIVERSIDE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-2300
Practice Address - Country:US
Practice Address - Phone:920-433-9920
Practice Address - Fax:920-433-9927
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-10-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI45699207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34438500Medicaid
WI07515 0006Medicare ID - Type Unspecified
WIH97986Medicare UPIN