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833 Pennsylvania Ave Suite 103 Sheboygan WI 53081-4452 | |
(920) 458-9434 | |
(920) 458-6313 |
Full Name | |
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Speciality | Clinic/center |
Location | 833 Pennsylvania Ave, Sheboygan, Wisconsin |
Authorized Official Name and Position | Vincent A Graser (CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 9204589434 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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833 Pennsylvania Ave. Po Box 1143 Sheboygan WI 53082-1143 Ph: (920) 458-9434 | 833 Pennsylvania Ave Suite 103 Sheboygan WI 53081-4452 Ph: (920) 458-9434 |
NPI Number | 1740365378 |
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Provider Enumeration Date | 10/25/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740365378 | NPI | - | NPPES |
42126500 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 1501 (Wisconsin) | Primary |
Marsho Family Medical Group, Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1703 N Taylor Dr, Sheboygan, WI 53081 Phone: 920-457-4438 Fax: 920-451-3214 | |
Lakeshore Community Health Care, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1721 Saemann Avenue, Sheboygan, WI 53081 Phone: 920-783-6633 Fax: 920-783-6392 | |
Aurora Health Care Central, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2629 N 7th St, Sheboygan, WI 53083 Phone: 920-451-5000 | |