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Organization

GREEN BAY CARDIOTHORACIC & VASCULAR LLC

Active
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Organization

GREEN BAY CARDIOTHORACIC & VASCULAR LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEVEN J GERNDT MD (OWNER)
(920) 433-9621
Entity
Organization

Contact information

Practice address
720 S VAN BUREN ST, SUITE 303, GREEN BAY, WI 54301-3538
(920) 433-9621
(920) 433-0565
Mailing address
720 SO VAN BUREN ST, SUITE 303, GREEN BAY, WI 54301
(920) 433-9621
(920) 433-0565

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32897600
WI
01
CG7604
RAILROAD MEDICARE
WI
Enumeration date
02/12/2007
Last updated
12/14/2011
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