Premier Surgical of Wisconsin SC
Premier Surgical of Wisconsin SC is a Surgery Physician in Maintowoc, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2006.
- Licensed in
- WI
- In the registry since
- 2006
Practice location Address checks out
940 Maritime Dr Ste 4Maintowoc, WI 54220-2960
Phone: (920) 686-7900
Fax: (920) 686-7984
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Surgery Physician (primary) | Taxonomy 208600000X · Licence 19677020 (WI) |
|---|
Record details
| NPI number | 1679671408 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Kimberly Ridl — President · (920) 686-7900 |
| NPI enumerated | September 20, 2006 |
| Last updated in NPPES | August 8, 2023 |
| Certification date | August 8, 2023 |
| Mailing address | 940 Maritime Dr, Ste 4, Manitowoc, WI 54220-2960 |