Individual
JOHN SNELLGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4597
(920) 929-2300
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
7463420
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2019
Last updated
07/19/2022
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