Organization
SURSUM CORDA, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD J. COLEMAN M.D. (PRESIDENT)
(920) 431-3140
Entity
Organization
Contact information
Practice address
900 S. WEBSTER AVENUE, GREEN BAY, WI 54301
(920) 431-3140
(920) 431-3142
Mailing address
900 S. WEBSTER AVENUE, GREEN BAY, WI 54301
(920) 431-3140
(920) 431-3142
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
31207
WI
Other
Enumeration date
03/29/2007
Last updated
05/16/2011
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