Individual
STEPHEN T CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 MAIN ST, NEENAH, WI 54956-2570
(920) 727-5810
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41787
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34101500
—
WI
Enumeration date
09/07/2005
Last updated
03/04/2020
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