Organization
COMMUNITY HEALTH NETWORK
Active
Other names
CHN Medical Center EastRidge
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN RUEDINGER (VICE PRESIDENT)
(920) 361-5988
Entity
Organization
Contact information
Practice address
W832 STATE ROAD 91, STE 3, BERLIN, WI 54923-8821
(920) 361-6400
(920) 361-6407
Mailing address
W832 STATE ROAD 91, STE 3, BERLIN, WI 54923-8821
(920) 361-6400
(920) 361-6407
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45822
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11011000
—
WI
Enumeration date
03/16/2011
Last updated
07/07/2011
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