Maryjo Neustifter, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

32219 Issued in WI

Practice address

1821 S Webster Ave
Green Bay, WI 54301-2253

Phone

(920) 496-4700

Fax

(920) 436-1379

NPI assigned

Jul 9, 2006

Last updated

Jul 31, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1629001847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "address_2": "PREVEA HEALTH",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700",
            "fax_number": "920-436-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012253",
            "telephone_number": "920-496-4700",
            "fax_number": "920-436-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUSTIFTER",
        "first_name": "MARYJO",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "32219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31738100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neurology Consultants of NE
• Neuropsychology of Green Bay LTD
• Neurotech, LLC
• Neurotech, LLC
• Linda M Neuser, CRNA
• Robert Paul Neustifter, PTA
• Brittany Neveau, APRN
• Elizabeth Grace Neveau, DPT
• Kevin Neveau, DO
• Mallory Neville

• Obstetrics & Gynecology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Obstetrics & Gynecology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.