Organization
MINISTRY HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD GRIFFITH (PHYSICIAN ASSISTANT)
(920) 743-5566
Entity
Organization
Contact information
Practice address
323 SOUTH 18TH AVE, 323 SOUTH 18TH AVE, STURGEON BAY, WI 54235-1495
(262) 285-3483
Mailing address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
(920) 743-5566
(800) 522-8919
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
1593
GA
Other
Enumeration date
05/30/2008
Last updated
05/30/2008
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