Individual
DR. IAN A SPROAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2941 S RIDGE RD, GREEN BAY, WI 54304-5517
(920) 336-4096
(920) 336-8093
Mailing address
2941 S RIDGE RD, GREEN BAY, WI 54304-5517
(920) 336-4096
(920) 336-8093
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
32061
WI
2085R0204X
Vascular & Interventional Radiology Physician
32061
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31709600
—
WI
Enumeration date
01/26/2007
Last updated
08/17/2010
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