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Individual

DR. GARY THEODORE SWEET JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2606 STEWART AVE STE 200, WAUSAU, WI 54401-5449
(715) 847-2022
Mailing address
2400 PINE RIDGE BLVD, WAUSAU, WI 54401-7803
(715) 847-2022

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
47143-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
35369600
WI
Enumeration date
05/25/2007
Last updated
08/03/2021
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