Organization
AURORA BAY AREA MEDICAL GROUP, LLC
Active
Other names
Aurora Pediatric & Adolescent Med
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY W LINEBERRY M.D. (BOARD CHAIRMAN)
(920) 288-8612
Entity
Organization
Contact information
Practice address
1510 UNIVERSITY DR, MARINETTE, WI 54143-4131
(715) 735-3998
(715) 735-0312
Mailing address
3100 SHORE DR, MARINETTE, WI 54143-4242
(715) 735-1794
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295122729
—
WI
Enumeration date
02/02/2016
Last updated
02/02/2016
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