Individual
SANDRA GROENEWOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-2300
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 720-2300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
36918
WI
2084P0800X
Psychiatry Physician
Primary
36918
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32309500
—
WI
Enumeration date
06/23/2006
Last updated
08/04/2023
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