| Fmc Ashwaubenon Internal Medicine & Pediatrics | |
|
1630 Commanche Ave Green Bay WI 54313-6089 | |
| (920) 497-7771 | |
| Not Available |
| Full Name | Fmc Ashwaubenon Internal Medicine & Pediatrics |
|---|---|
| Speciality | Family Medicine |
| Location | 1630 Commanche Ave, Green Bay, Wisconsin |
| Authorized Official Name and Position | Denise K Stroobants (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9204337864 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fmc Ashwaubenon Internal Medicine & Pediatrics 1630 Commanche Ave Green Bay WI 54313-6089 Ph: (920) 497-7771 | Fmc Ashwaubenon Internal Medicine & Pediatrics 1630 Commanche Ave Green Bay WI 54313-6089 Ph: (920) 497-7771 |
| NPI Number | 1396707089 |
|---|---|
| Provider Enumeration Date | 04/06/2006 |
| Last Update Date | 10/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396707089 | NPI | - | NPPES |
| 52D0907183 | Other | WI | CLIA # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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