| Doctor Name: | DR. STUART J WERTHEIMER |
| NPI Number: | 1124039086 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 5901000816 |
| Business Practice Address: | 608 W Brown St Waupun, WI - 539631702 |
| Business Phone Number: | 9203249301 |
| Business Fax Number: | 9203248428 |
| Mailing Address: | 420 E Division St, FOND DU LAC |
| State: | WI |
| Postal Code: | 549354560 |
| Phone Number: | 9209268340 |
| Fax Number: | 9209268370 |
| NPI Enumeration Date: | 08/10/2006 |
| NPI Last Update Date: | 11/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 5901000816 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |