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Organization

BAYCARE CLINIC LLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHRIS JAY AUGUSTIAN CPA (CHIEF EXECUTIVE OFFICER)
(920) 490-9046
Entity
Organization

Contact information

Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 490-9046
(920) 405-5388

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
207L00000X
Anesthesiology Physician
207LP2900X
Pain Medicine (Anesthesiology) Physician
207P00000X
Emergency Medicine Physician
Primary
207RC0000X
Cardiovascular Disease Physician
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
207RI0011X
Interventional Cardiology Physician
207RP1001X
Pulmonary Disease Physician
207T00000X
Neurological Surgery Physician
207W00000X
Ophthalmology Physician
207X00000X
Orthopaedic Surgery Physician
207Y00000X
Otolaryngology Physician
208100000X
Physical Medicine & Rehabilitation Physician
208200000X
Plastic Surgery Physician
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14-0-B1-1013-0
BCBSM
MI
05
32874000
WI
01
34-0-B1-1010
BCBSM
MI
05
4082659
MI
01
CI3977
RAILROAD
WI
01
CI3978
RAILROAD
MI
Enumeration date
06/20/2006
Last updated
03/31/2022
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