Organization
COMMUNITY HEALTH NETWORK
Active
Other names
CHN Medical Center Wautoma
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN RUEDINGER (VICE PRESIDENT)
(920) 361-5988
Entity
Organization
Contact information
Practice address
N2934 STATE ROAD 22, WAUTOMA, WI 54982-5267
(920) 787-4613
(920) 787-5433
Mailing address
PO BOX 650, WAUTOMA, WI 54982-0650
(920) 787-4613
(920) 787-5433
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25430
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11011000
—
WI
Enumeration date
03/29/2011
Last updated
03/29/2011
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