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Individual

DR. RUTH CALLAWAY WARREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1726 SHAWANO AVE, GREEN BAY, WI 54303-3216
(920) 884-3135
(920) 884-3144
Mailing address
1726 SHAWANO AVE, GREEN BAY, WI 54303-3216
(920) 884-3135
(920) 884-3144

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
50362
WI
207RX0202X
Medical Oncology Physician
5101018539
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100004011
WI
01
1124096185
BCBS ANTHEM
WI
05
1124096185
MI
Enumeration date
03/08/2006
Last updated
12/20/2021
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