Organization
REGIONAL GENERAL & VASCULAR SURGEONS, S. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM M BEDUZE (OFFICE ADMINISTRATOR)
(262) 567-1499
Entity
Organization
Contact information
Practice address
1185 CORPORATE CENTER DR, SUITE 200, OCONOMOWOC, WI 53066-4845
(262) 567-1499
(262) 567-4502
Mailing address
1185 CORPORATE CENTER DR, SUITE 200, OCONOMOWOC, WI 53066-4845
(262) 567-1499
(262) 567-4502
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30821400
—
WI
Enumeration date
02/10/2006
Last updated
01/30/2008
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