Provider Demographics
NPI:1548433832
Name:STREGE, WILLIAM G SR
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:G
Last Name:STREGE
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 2ND ST
Mailing Address - Street 2:
Mailing Address - City:TWIN LAKES
Mailing Address - State:WI
Mailing Address - Zip Code:53181-9632
Mailing Address - Country:US
Mailing Address - Phone:262-877-3389
Mailing Address - Fax:262-877-3389
Practice Address - Street 1:1606 2ND ST
Practice Address - Street 2:
Practice Address - City:TWIN LAKES
Practice Address - State:WI
Practice Address - Zip Code:53181-9632
Practice Address - Country:US
Practice Address - Phone:262-877-3389
Practice Address - Fax:262-877-3389
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41744700Medicaid