Individual
AMY VAN GHEEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1860 SHAWANO AVE, GREEN BAY, WI 54303-2667
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
60425-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100031424
—
WI
Enumeration date
06/18/2009
Last updated
02/14/2024
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