Organization
BAYCARE CLINIC LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS J AUGUSTIAN CEO (CEO / CHIEF EXECUTIVE OFFICER)
(920) 490-9046
Entity
Organization
Contact information
Practice address
4801 EXPO DRIVE, MANITOWOC, WI 54220
(920) 684-4429
(920) 684-6892
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 490-9046
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
2084N0400X
Neurology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
07/13/2015
Last updated
04/13/2022
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