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SEQUOIA INTEGRATIVE MEDICAL SERVICES LLC NPI 1790312171


NPI Information

NPI: 1790312171
Provider Name: SEQUOIA INTEGRATIVE MEDICAL SERVICES LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1351 ONTARIO RD
GREEN BAY, WI
ZIP 54311
Phone: (920) 328-1220
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SEQUOIA INTEGRATIVE MEDICAL SERVICES LLC is a family medicine in Green Bay, WI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SEQUOIA INTEGRATIVE MEDICAL SERVICES LLC NPI is 1790312171. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1351 ONTARIO RD
GREEN BAY, WI
ZIP 54311-302
Phone: (920) 328-1220

The provider's authorized official is Mary K Friess .
The authorized official title is President and has the following contact phone number (920) 579-1027.

The enumeration date for this NPI number is 3/25/2020 and was last updated on 6/24/2020.


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
1207QG0300XFamily MedicineGeriatric MedicineNo
2104100000XSocial WorkerNo
3207Q00000XFamily MedicineYes

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
136015700MEDICAIDWISCONSIN

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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