Individual
DR. SUZANNE S HEROLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1411 N TAYLOR DR, SHEBOYGAN, WI 53081-3043
(920) 496-4700
(920) 496-4705
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40654020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32500800
—
WI
Enumeration date
03/14/2006
Last updated
09/19/2016
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