Organization
FROEDTERT MANITOWOC MEDICAL GROUP, LLC
Active
Other names
Froedtert Northeast Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL W DEGERE DPM (SECRETARY/TREASURER)
(920) 320-2095
Entity
Organization
Contact information
Practice address
2300 WESTERN AVE, MANITOWOC, WI 54220-3712
(920) 320-2436
Mailing address
400 WOODLAND PRIME STE 103, N74 W12501 LEATHERWOOD COURT, MENOMONEE FALLS, WI 53051-4490
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/16/2021
Last updated
07/07/2025
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