Organization
IHC BEAVER DAM EMERGENCY PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER KENNEDY (AUTHORIZED OFFICIAL)
(207) 807-9009
Entity
Organization
Contact information
Practice address
707 S UNIVERSITY AVE, BEAVER DAM, WI 53916-3027
(954) 939-5000
(484) 342-5201
Mailing address
PO BOX 80268, PHILADELPHIA, PA 19101-1268
(954) 939-5000
(484) 342-5201
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
06/04/2007
Last updated
09/19/2025
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