Organization
EVERGREEN SURGICAL, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN C. IMMERMAN M.D. (PRESIDENT)
(715) 832-1044
Entity
Organization
Contact information
Practice address
719 W HAMILTON AVE, SUITE C, EAU CLAIRE, WI 54701-6968
(715) 832-1044
(715) 832-0520
Mailing address
719 W HAMILTON AVE, SUITE C, EAU CLAIRE, WI 54701-6968
(715) 832-1044
(715) 832-0520
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32865800
—
WI
Enumeration date
05/04/2006
Last updated
07/23/2021
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