Individual
JAMES EDWARD MEMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1543 PARK PL, SUITE 400, GREEN BAY, WI 54304-1970
(920) 497-0100
(920) 497-0101
Mailing address
4492 CHOCTAW TRL, GREEN BAY, WI 54313-6781
(920) 380-0100
(920) 380-0101
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
29183
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6343730001
DMCR / EYEGLASSES
WI
Enumeration date
07/14/2006
Last updated
10/29/2021
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