Basic Information
| Provider Information | |||||||||
| NPI: | 1972570224 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEMARBRE | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 721 AMERICAN AVE STE 108 | ||||||||
| Address2: | PROHEALTH CARE REGIONAL CANCER CENTER | ||||||||
| City: | WAUKESHA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 531865031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2629282570 | ||||||||
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| Practice Location | |||||||||
| Address1: | W359N7430 BROWN ST | ||||||||
| Address2: | |||||||||
| City: | OCONOMOWOC | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530661120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2624680115 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | 31845 | WI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 31672800 | 05 | WI | MEDICAID |