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Organization
GREEN BAY CHEST AND INFECTIOUS DISEASES SC
Active
Organization
GREEN BAY CHEST AND INFECTIOUS DISEASES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD DALE DAVIS M.D. (PRESIDENT)
(920) 433-7516
Entity
Organization
Contact information
Practice address
704 S WEBSTER AVE, SUITE 102, GREEN BAY, WI 54301-3528
(920) 433-7516
(920) 433-7464
Mailing address
704 S WEBSTER AVE, SUITE 102, GREEN BAY, WI 54301-3528
(920) 433-7516
(920) 433-7464
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
30054
WI
Other
Enumeration date
10/01/2007
Last updated
10/12/2007
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