Individual
GANNA V OOSTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5000 MEMORIAL DR, TWO RIVERS, WI 54241-3900
(920) 794-5000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
45000
WI
208M00000X
Hospitalist Physician
Primary
45000
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34342900
—
WI
01
—
390806395002
TRICARE
WI
01
—
45000
TOUCHPOINT
WI
01
—
H79622
CIGNA
WI
Enumeration date
08/29/2006
Last updated
03/27/2024
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