Individual
DR. KEITH KENJI SANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-3500
(920) 433-7932
Mailing address
6400 INDUSTRIAL LOOP, GREENDALE, WI 53129-2452
(414) 423-4100
(414) 423-4134
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
39387020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32397100
—
WI
Enumeration date
11/25/2005
Last updated
07/08/2007
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