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

Community Memorial Hospital, Incorporated

Organization Surgery Physician · NPI 1093096224

Community Memorial Hospital, Incorporated is a Surgery Physician in Green Bay, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2011.

Licensed in
WI
In the registry since
2011

Practice location Address checks out

1726 Shawano Ave
Green Bay, WI 54303-3216
Phone: (920) 360-3787
Fax: (888) 848-0225
Show map & directions

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

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 39597-20 (WI)

Record details

NPI number1093096224
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCommunity Memorial Hospital, Incorporated
Authorized official Daniel Degroot — Ceo · (920) 846-3444
Other names D/B/A Breast Surgery Experts Of Northeast Wisconsin Llc
NPI enumeratedSeptember 1, 2011
Last updated in NPPESJanuary 13, 2012
Mailing address25630 Network Pl, Chicago, IL 60673-1256

Other providers in Green Bay