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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