Organization
SPINE NEUROSURGERY INST OF NE WI S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN M PEREIRA M.D. (PRESIDENT)
(920) 846-8057
Entity
Organization
Contact information
Practice address
835 S MAIN ST, SUITE 1, OCONTO FALLS, WI 54154-1282
(920) 846-8057
(920) 846-4588
Mailing address
3409 NICOLET DR, GREEN BAY, WI 54311-7203
(920) 846-8057
(920) 846-4588
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
39920-20
WI
Other
Enumeration date
01/26/2006
Last updated
10/20/2008
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