| Prevea Regional | |
|
2710 Executive Dr Green Bay WI 54304-5496 | |
| (920) 496-4700 | |
| (920) 496-4705 |
| Full Name | Prevea Regional |
|---|---|
| Speciality | Family Medicine |
| Location | 2710 Executive Dr, Green Bay, Wisconsin |
| Authorized Official Name and Position | Richard Rolston (PRESIDENT AND CEO) |
| Authorized Official Contact | 9204964700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prevea Regional Po Box 19070 Prevea Health Regional Green Bay WI 54307-9070 Ph: (920) 496-4700 | Prevea Regional 2710 Executive Dr Green Bay WI 54304-5496 Ph: (920) 496-4700 |
| NPI Number | 1194748061 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 09/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194748061 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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