Individual
DOUGLAS C GREMBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14353 STATE HIGHWAY 32 64, MOUNTAIN, WI 54149-9656
(715) 276-1600
(715) 276-1800
Mailing address
14353 STATE HIGHWAY 32 64, MOUNTAIN, WI 54149-9656
(715) 276-1600
(715) 276-1800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23967-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11014110
—
WI
01
—
1568552958
MPCC NPI
WI
01
—
1851477913
CMH NPI
WI
Enumeration date
05/27/2005
Last updated
09/02/2014
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