Individual
ROBERT DAVID SOUTHWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2253 W MASON ST, GREEN BAY, WI 54303-4706
(920) 327-7300
Mailing address
2253 W MASON ST, GREEN BAY, WI 54303-4706
(920) 327-7300
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
37060
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32424200
—
WI
Enumeration date
07/18/2006
Last updated
11/24/2021
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