National Provider Identifier Database

MARK A VAN ETTEN
Geriatric Medicine

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.


Contact Information

MARK A VAN ETTEN
707 ASH ST
SPOONER, WI54801-1234
Phone: 715-635-2151
Fax: 715-635-8768
Website:
Specialty Taxonomy Code
* Geriatric Medicine 207QG0300X

* Indicates primary specialty

NPI Profile & details for MARK A VAN ETTEN

NPI Number 1568480614
Credentials
Entity Individual
Enumeration date 07/17/2006
Last updated 05/09/2011 - About 15 years ago
Sole proprietor1 No
Identifiers
  • WI License #: 25178-020
  • WI Medicaid: 30518900
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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