Individual
MARC GRODSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
670 CORMIER RD, GREEN BAY, WI 54304-4824
(920) 494-9685
Mailing address
670 CORMIER RD, GREEN BAY, WI 54304-4824
(920) 494-9685
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD041610
DC
208C00000X
Colon & Rectal Surgery Physician
Primary
62935-20
WI
Other
Enumeration date
07/23/2007
Last updated
10/16/2014
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