Individual
PAUL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301
(920) 433-3500
Mailing address
225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4257
(920) 433-3500
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
61713-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2012
Last updated
06/27/2018
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