Organization
GREEN BAY CHEST AND INFECTIOUS DISEASES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD DALE DAVIS M.D. (PRESIDENT)
(920) 433-7516
Entity
Organization
Contact information
Practice address
704 S WEBSTER AVE, SUITE 102, GREEN BAY, WI 54301-3528
(920) 433-7516
(920) 433-7464
Mailing address
704 S WEBSTER AVE, SUITE 102, GREEN BAY, WI 54301-3528
(920) 433-7516
(920) 433-7464
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
30054
WI
Other
Enumeration date
10/01/2007
Last updated
10/12/2007
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