MARK W DE CLUTE
Radiology (Diagnostic Radiology)

Address: 2727 Plaza Drive, Wausau, WI 54401

MARK W DE CLUTE (NPI# 1417057142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417057142
Entity Type Individual
Full Name MARK W DE CLUTE
Gender Male
Credential MD
Practice Address 2727 Plaza Drive
Wausau
WI 54401
US
Practice Telephone 7158473000
Mailing Address 1000 N Oak Ave
Marshfield
WI 54449-5777
US
Enumeration Date 2006-09-23
Last Update Date 2007-07-08
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
36415 WI Allopathic & Osteopathic Physicians

Other Provider Identifiers

Identifier State Issuer Type Code
32110100 WI MEDICAID

Physician Overview

PECOS Associate Control (PAC) ID 4486689338
by Medicare Provider Enrollment and Chain/Ownership System (PECOS)
Professional Enrollment ID I20050929000728
Last Name DECLUTE
First Name MARK
Middle Name W
Credential MD
Organization Legal Name MARSHFIELD CLINIC INC
Location 2727 Plaza Dr, Wausau Center, Wausau, WI 54401-4129
Medical School UNIVERSITY OF WISCONSIN MEDICAL SCHOOL
Graduation Year 1983
Primary Specialty DIAGNOSTIC RADIOLOGY
Group Practice PAC ID 2264345206
Number of Group Practice Members 928

Office Location

Street Address 2727 PLAZA DRIVE
City WAUSAU
State WI
Zip Code 54401

Providers in the same location

NPI Name Taxonomy Address Enumeration
1568572642 Jane L Frankson Pediatrics 2727 Plaza Drive, Wausau, WI 54401 2006-08-30
1689786857 Grace V Laynes Internal Medicine 2727 Plaza Drive, Wausau, WI 54401 2006-08-31
1265527543 David K Aughenbaugh Internal Medicine 2727 Plaza Drive, Wausau, WI 54401 2006-10-04
1205944162 John C Hunsicker Physician Assistant 2727 Plaza Drive, Wausau, WI 54401 2006-08-29
1407949886 Catherine E Ortscheid Nurse Practitioner 2727 Plaza Drive, Wausau, WI 54401 2006-09-30
1669582748 Edward H Groshan Pediatrics 2727 Plaza Drive, Wausau, WI 54401 2006-08-30
1184722928 Earl W Zabel Obstetrics & Gynecology 2727 Plaza Drive, Wausau, WI 54401 2006-09-20
1881799435 Dennis Reno Nurse Anesthetist, Certified Registered 2727 Plaza Drive, Wausau, WI 54401 2006-09-14
1700984556 Samir L Abadeer Obstetrics & Gynecology 2727 Plaza Drive, Wausau, WI 54401 2006-09-20
1700981388 S Paul Kim Anesthesiology 2727 Plaza Drive, Wausau, WI 54401 2006-09-14
Find all in the same location

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1457504110 Jason D. Schillinger Specialist/Technologist, Other - Surgical Technologist 5200 Humingbird Road, Suite 100, Wausau, WI 54401 2008-10-28
1316556053 Jerdie Manuel Ale · Jerdie Manuel Ale-Salvo Dentist - General Practice 2606 Stewart Ave, Wausau, WI 54401 2020-07-29
1699293241 Amanda Nedd Dietitian, Registered 425 Pine Ridge Boulevard Suite 220 C, Wausau, WI 54401 2017-09-05
1881091163 Judy Lao Dental Hygienist 413 North 17th Avenue, Wausau, WI 54401 2014-12-02
1164031464 Central Wisconsin Endodontic Specialists LLC · Mpc Endodontics Dentist - Endodontics 2606 Stewart Avenue, #102, Wausau, WI 54401 2020-07-23
1063739589 John W. Stilp, Dds, Sc Dentist - Oral and Maxillofacial Surgery 3000 Westhill Drive, Suite 301, Wausau, WI 54401 2010-04-23
1194296079 Beth Marie Wright · Beth Marie Greenberg Nurse Practitioner - Acute Care 333 Pine Ridge Blvd Ste 317, Wausau, WI 54401 2018-12-17
1336701895 Amy Kluetz Counselor - Professional 3000 Westhill Drive, Suite 100, Wausau, WI 54401 2019-07-05
1447657390 Pamela Jean Nielsen Dental Hygienist 413 N. 17th Ave., Wausau, WI 54401 2014-11-20
1295012011 Allison Waraksa Pharmacist 504 S. 17th Ave, Wausau, WI 54401 2011-11-08
Find all in zip 54401

Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1114152493 Jacob H. Martens Radiology - Diagnostic Radiology 414 Kent St, Wausau, WI 54403-6927 2009-05-15
1376555839 Stephen B Stine Radiology - Diagnostic Radiology 3200 Westhill Dr Ste 210, Wausau, WI 54401-4707 2006-08-13
1750700688 Endel Aleksander Sorra II Radiology - Diagnostic Radiology 333 Pine Ridge Blvd, Aspirus Hospital, Wausau, WI 54401 2014-04-08
1780014407 Aspirus Wausau Hospital, Inc · Aspirus Imaging-Westhill Radiology - Diagnostic Radiology 3200 Westhill Dr, Wausau, WI 54401-4705 2013-11-15
1063674224 Derrick Robson Siebert Radiology - Diagnostic Radiology 333 Pine Ridge Blvd, Wausau, WI 54401-4120 2008-06-30
1952490054 Aspirus Inc · Aspirus Imaging Radiology - Diagnostic Radiology 3200 Westhill Dr, Wausau, WI 54401-4705 2006-10-12
1306946025 Rosita S Go Radiology - Diagnostic Radiology 2727 Plaza Dr, Wausau, WI 54401-4129 2006-09-23
1922118512 Alan C Williams Radiology - Diagnostic Radiology 2727 Plaza Drive, Wausau, WI 54401 2006-08-30
1255343703 Vinay D Luthra Radiology - Diagnostic Radiology 3200 Westhill Dr Ste 210, Wausau, WI 54401-4707 2006-08-13
1992714810 John R Sorenson Radiology - Diagnostic Radiology 3200 Westhill Dr, Suite 210, Wausau, WI 54401-4705 2006-08-07
Find all providers in WAUSAU

Competitor

Search similar providers

City WAUSAU
Zip Code 54401

Providers with similar names

NPI Name Taxonomy Address Enumeration
1861136756 Amy Clute Licensed Practical Nurse 19 Bank St, Westfield, NY 14787-1311 2022-04-26
1114688769 Mark Rainier Nazareno · Mark Nazareno Nurse Practitioner - Family 1220 Valencia Dr, Tracy, CA 95377-8972 2022-01-05
1053065037 Mark Gosnell Internal Medicine - Pulmonary Disease 6781 Norris Ln, Elkridge, MD 21075-5727 2022-02-08
1619621018 Mark Machado Pharmacist 43 Belmont St, South Easton, MA 02375-1902 2022-02-05
1831842392 Mark P Dufrene Counselor 126 Rue Colette, Thibodaux, LA 70301-5628 2022-02-03
1730832726 Crystal A Mark Nurse Practitioner - Family 45 Eagle Ct, The Woodlands, TX 77380-1528 2022-01-31
1417600511 Mark Peterson Psychologist - Clinical 8911 Lakewood Dr # 26a, Windsor, CA 95492-7856 2022-01-28
1437802766 Mark Avery In Home Supportive Care 4501 Bridgeton Ln, Orlando, FL 32817-3828 2022-01-27
1215686696 Julissa Mark Peer Specialist 565 Union St Ne Ste 101, Salem, OR 97301-2416 2022-03-22
1083366579 Joe Mark Applegate Pharmacy 555 N Maize Rd, Wichita, KS 67212-4655 2022-01-25

Provide Additional Information

If you wish to provide additional information about MARK W DE CLUTE, please fill in the form below. Please note that the information provided here will be posted publicly on this page. Please do not leave any private information here. If you have privacy or any other concerns about the information on this page, please use this link to the contact form.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.