| (inactive) Marshfield Medical Center - Beaver Dam Waupun Center (hopd | |
|
180 Gateway Dr Waupun WI 53963 | |
| (920) 345-1306 | |
| (920) 345-1325 |
| Full Name | (inactive) Marshfield Medical Center - Beaver Dam Waupun Center (hopd |
|---|---|
| Speciality | Family Medicine |
| Location | 180 Gateway Dr, Waupun, Wisconsin |
| Authorized Official Name and Position | Gordon T Edwards (CFO/COO/AO) |
| Authorized Official Contact | 7153875823 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| (inactive) Marshfield Medical Center - Beaver Dam Waupun Center (hopd 1000 N Oak Ave Attn: Provider Enrollment Services/wwp Marshfield WI 54449-5703 Ph: (715) 389-0660 | (inactive) Marshfield Medical Center - Beaver Dam Waupun Center (hopd 180 Gateway Dr Waupun WI 53963 Ph: (920) 345-1306 |
| NPI Number | 1629374780 |
|---|---|
| Provider Enumeration Date | 02/07/2011 |
| Last Update Date | 03/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629374780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
New Medical Center, S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 160 Gateway Dr, Ste A, Waupun, WI 53963 Phone: 920-324-9899 Fax: 920-324-9898 | |
Mariano L. Rosales Jr., M.d. S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 600 Fern St, Waupun, WI 53963 Phone: 920-324-3559 Fax: 920-324-0258 |