Provider Demographics
NPI:1386738078
Name:NEUMANN, EDWIN HERBERT (OD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:HERBERT
Last Name:NEUMANN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W7384 SYLVESTER ROAD
Mailing Address - Street 2:
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636-9272
Mailing Address - Country:US
Mailing Address - Phone:608-526-2044
Mailing Address - Fax:
Practice Address - Street 1:38020 HWY 18
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU CHIEN
Practice Address - State:WI
Practice Address - Zip Code:53821
Practice Address - Country:US
Practice Address - Phone:608-326-7745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2667152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIUO5595Medicare UPIN
WI00047622Medicare ID - Type Unspecified