Organization
OB-GYN ASSOC OF GREEN BAY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT KNOX DEMOTT MD (OWNER OPERATOR)
(920) 468-3443
Entity
Organization
Contact information
Practice address
704 S WEBSTER AVE, STE 300, GREEN BAY, WI 54301
(920) 468-3443
(920) 432-6313
Mailing address
1350 WITTMANN DRIVE, HEALTHCARE MANAGEMENT CONSULTANTS, MENASHA, WI 54952-3809
(920) 886-6565
(920) 886-6570
Taxonomy
Speciality
Code
Description
License number
State
207VC0200X
Critical Care Medicine (Obstetrics & Gynecology) Physician
Primary
—
WI
364SF0001X
Family Health Clinical Nurse Specialist
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174547244
KIM SHEFCHIK PAC NPI
—
05
—
30661000
—
WI
05
—
30984300
—
WI
05
—
32400300
—
WI
05
—
41963900
—
WI
05
—
41964300
—
WI
05
—
43977500
—
WI
Enumeration date
11/03/2006
Last updated
07/01/2008
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