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Organization
PATHOLOGY CONSULTANTS OF GREEN BAY, S.C.
Active
Organization
PATHOLOGY CONSULTANTS OF GREEN BAY, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS S FREDEEN M.D. (PRESIDENT)
(920) 433-3653
Entity
Organization
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-3653
Mailing address
200 E WASHINGTON ST, P O BOX 8031, APPLETON, WI 54911-5490
(800) 236-1489
(920) 739-0124
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32692200
—
WI
Enumeration date
05/15/2006
Last updated
08/22/2020
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