Individual
SCOTT T WESLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2845 GREENBRIER RD, STE 310, GREEN BAY, WI 54311-6519
(920) 288-8300
(920) 288-8305
Mailing address
164 N BROADWAY, GREEN BAY, WI 54303-2728
(920) 965-4055
(920) 405-5388
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
49538
WI
208M00000X
Hospitalist Physician
49538
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104836113
—
WI
Enumeration date
08/09/2006
Last updated
03/07/2023
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