Organization
GREEN BAY HEARTCARE S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER A. FERGUS MD (PRESIDENT)
(920) 496-8877
Entity
Organization
Contact information
Practice address
1727 SHAWANO AVE, SUITE 201, GREEN BAY, WI 54303-3268
(920) 496-8877
(920) 496-3061
Mailing address
1727 SHAWANO AVE, SUITE 201, GREEN BAY, WI 54303-3268
(920) 496-8877
(920) 496-3061
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32864300
—
WI
Enumeration date
01/23/2006
Last updated
08/22/2020
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