Individual
NICHOLAS EDWARD COOROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
720 S VANBUREN ST, SUITE 201, GREEN BAY, WI 54301-3534
(920) 433-7488
(920) 433-7439
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
62822-20
WI
Other
Enumeration date
05/10/2013
Last updated
12/28/2020
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