Organization
CARDIOLOGY ASSOCIATES OF GREEN BAY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNE L STAMNES (CREDENTIALING)
(920) 433-3640
Entity
Organization
Contact information
Practice address
744 S. WEBSTER AVE, 2ND FLOOR, GREEN BAY, WI 54301-3505
(920) 433-3640
(920) 433-3716
Mailing address
PO BOX 22425, 744 S. WEBSTER AVE, GREEN BAY, WI 54305-2425
(920) 433-3640
(920) 433-3716
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102641408
—
MI
05
—
102929025
—
MI
05
—
103318417
—
MI
05
—
104270274
—
MI
05
—
104277785
—
MI
05
—
104277810
—
MI
05
—
104284055
—
MI
05
—
104432532
—
MI
05
—
104692012
—
MI
05
—
105189687
—
MI
05
—
109521635
—
MI
01
—
P00456684
RAILROAD MEDICARE
WI
Enumeration date
11/03/2006
Last updated
04/20/2010
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