Organization
BELLIN MEMORIAL HOSPITAL INC
Active
Other names
FMC BELLIN HEALTH FAST CARE GREEN BAY EAST, Bellin Health Fast Care East
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE K STROOBANTS (CREDENTIALING SPECIALIST)
(920) 433-7864
Entity
Organization
Contact information
Practice address
1976 LIME KILN RD, GREEN BAY, WI 54311-4417
(920) 406-9865
(920) 406-9867
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033172390
—
WI
01
—
52D1054543
CLIA WAIVER
WI
Enumeration date
05/18/2006
Last updated
10/18/2021
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