D/B/A BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN LLC - NPI 1093096224

Q: What is Community Memorial Hospital, Incorporated's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

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About D/b/a Breast Surgery Experts Of Northeast Wisconsin Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

D/B/A BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN LLC (NPI 1093096224) is a healthcare organization registered as a surgery in Green Bay, Wisconsin and active in the NPI registry since September 2011. The organization lists Daniel Degroot, Ceo, as its authorized official.

NPPES Registry Identity

NPI1093096224

Entity TypeOrganization

Primary Taxonomy208600000X

Legal Business NameCOMMUNITY MEMORIAL HOSPITAL, INCORPORATED

Location Address1726 SHAWANO AVEGreen Bay, WI 54303-3216

Mailing Address25630 Network PlChicago, IL 60673-1256 · (920) 360-3787 · Fax (888) 848-0225

Phone(920) 360-3787

Fax(888) 848-0225

Organization SubpartYes

Authorized OfficialDaniel DegrootCeo · (920) 846-3444

Enumeration DateSeptember 1, 2011

Last NPPES UpdateJanuary 13, 2012

✔ NPI 1093096224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in WI · 39597-20

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

1726 SHAWANO AVE, Green Bay, WI 54303

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Other Names 1

Doing Business AsD/b/a Breast Surgery Experts Of Northeast Wisconsin Llc

Other Identifiers 3

Other1851477913WI · Cmh Npi

Other1750302089WI · Provider

OtherWI2552WI · Medicare Ptan

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUNHONG PACE NP

Nurse Practitioner (Family)