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General NPI Number Information
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NPI Number | 1265320949
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Entity Type | Organization
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Legal Business Name | ALTEA MEDICAL WISCONSIN S.C.
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 2961 SAINT ANTHONY DR
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City | GREEN BAY
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State | WI
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Zip | 54311-5860
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Country | US
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Telephone | 888-408-7008
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Fax |
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Provider Business Mailing Address
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Address Line | 400 E RIVULON BLVD STE 103
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City | GILBERT
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State | AZ
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Zip | 85297-0096
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF RCM
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Name | MARY ARNDT
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Credential |
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Telephone | 775-287-3290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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