Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Beaver Dam Community Hospitals Inc

Organization Family Medicine Physician · NPI 1629374780

Beaver Dam Community Hospitals Inc is a Family Medicine Physician in Waupun, Wisconsin. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

180 Gateway Dr
Waupun, WI 53963
Phone: (920) 345-1306
Fax: (920) 345-1325
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1629374780
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMarshfield Clinic Health System Inc
Authorized official Gordon Edwards — Cfo/Coo/Ao · (715) 387-5823
Other names Inactive) Marshfield Medical Center - Beaver Dam Waupun Center (Hopd
NPI enumeratedFebruary 7, 2011
Last updated in NPPESMarch 3, 2022
Certification dateMarch 3, 2022
Mailing address1000 N Oak Ave, Attn: Provider Enrollment Services/Wwp, Marshfield, WI 54449-5703

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