Organization
BAYCARE CLINIC LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS JAY AUGUSTIAN C.P.A (CHIEF EXECUTIVE OFFICER)
(920) 405-5382
Entity
Organization
Contact information
Practice address
1346 E GREEN BAY ST, SHAWANO, WI 54166-2210
(920) 288-5555
(920) 288-5550
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 490-9046
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208800000X
Urology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
05/17/2011
Last updated
04/13/2022
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