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GREEN BAY CARDIOTHORACIC & VASCULAR LLC NPI 1538306410


NPI Information

NPI: 1538306410
Provider Name: GREEN BAY CARDIOTHORACIC & VASCULAR, LLC
Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Organization
Address:
1711 S STEPHENSON AVE
IRON MOUNTAIN, MI
ZIP 49801
Phone: (920) 433-9621
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GREEN BAY CARDIOTHORACIC & VASCULAR, LLC is a thoracic surgery cardiothoracic vascular surgery in Iron Mountain, MI. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. GREEN BAY CARDIOTHORACIC & VASCULAR, LLC NPI is 1538306410. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1711 S STEPHENSON AVE
IRON MOUNTAIN, MI
ZIP 49801-639
Phone: (920) 433-9621
Fax: (920) 433-0565

The provider's authorized official is Mary Jo Holewinski .
The authorized official title is Office Manager and has the following contact phone number (920) 433-9621.

The enumeration date for this NPI number is 1/14/2009 and was last updated on 1/16/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
132897600MEDICAIDWISCONSIN
21659412401OTHERWISCONSINMEDICARE NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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