| Door County Medical Center Sister Bay | |
|
2345 Canterbury Lane Sister Bay WI 54234 | |
| (920) 868-3511 | |
| Not Available |
| Full Name | Door County Medical Center Sister Bay |
|---|---|
| Speciality | Clinic/Center |
| Location | 2345 Canterbury Lane, Sister Bay, Wisconsin |
| Authorized Official Name and Position | Andrew S Laluzerne (CFO) |
| Authorized Official Contact | 9207463729 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Door County Medical Center Sister Bay 323 S 18th Ave Sturgeon Bay WI 54235-1401 Ph: (920) 743-5566 | Door County Medical Center Sister Bay 2345 Canterbury Lane Sister Bay WI 54234 Ph: (920) 868-3511 |
| NPI Number | 1508198961 |
|---|---|
| Provider Enumeration Date | 02/09/2010 |
| Last Update Date | 04/12/2023 |
| Medicare PECOS PAC ID | 5395735088 |
|---|---|
| Medicare Enrollment ID | O20081107000147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508198961 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Samantha M Prust |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740899285 PECOS PAC ID: 9032584438 Enrollment ID: I20230701000436 |
Aurora Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2521 S Bay Shore Dr, Sister Bay, WI 54234 Phone: 920-854-2347 | |
Partners In Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10539 Applewood Rd, Sister Bay, WI 54234 Phone: 920-854-4154 Fax: 920-854-6826 |