Organization
NEW SURGICAL ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL L HERLACHE (ACCOUNTS RECEIVABLE REPRESENTATIVE)
(920) 497-7678
Entity
Organization
Contact information
Practice address
670 CORMIER RD, GREEN BAY, WI 54304-4824
(920) 494-9685
(920) 494-8417
Mailing address
670 CORMIER ROAD, GREEN BAY, WI 54304
(920) 494-9685
(920) 494-8417
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34387
PETER M FALK
—
01
—
35428
LICENSE JAMES M KEMMERLIN
—
01
—
39619
LICENSE PETER W DAVIS
—
01
—
44472
LICENSE SCOTT L RUGGLES
—
01
—
CI5843
RAILROAD MEDICARE
WI
Enumeration date
08/16/2006
Last updated
04/24/2017
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