Individual
PAMELA J VANDERWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-4160
Mailing address
11516 N PORT WASHINGTON RD STE 107, MEQUON, WI 53092-3478
(262) 241-5040
(262) 241-5261
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
29877
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31627700
—
WI
Enumeration date
06/02/2006
Last updated
10/30/2025
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