Organization
HEART AND VASCULAR OF WISCONSIN, SC
Active
Other names
Heart and Vascular Institute of Wisconsin
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY SOBAL (CEO)
(904) 574-6211
Entity
Organization
Contact information
Practice address
5045 W GRANDE MARKET DR, APPLETON, WI 54913-8517
(920) 886-9380
(920) 886-9381
Mailing address
PO BOX 610, GREEN BAY, WI 54305-0610
(920) 886-9380
(920) 886-9381
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100088147
—
WI
Enumeration date
01/08/2019
Last updated
10/24/2022
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