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General NPI Number Information
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NPI Number | 1295122729
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Entity Type | Organization
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Legal Business Name | AURORA BAY AREA MEDICAL GROUP LLC
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 12/14/2020
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Provider Practice Location Address
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Address Line | 3003 UNIVERSITY DR
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City | MARINETTE
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State | WI
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Zip | 54143
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Country | US
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Telephone | 715-735-1737
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Fax | 715-735-1794
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Provider Business Mailing Address
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Address Line | 3003 UNIVERSITY DR
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City | MARINETTE
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State | WI
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Zip | 54143-4110
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Country | US
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Telephone | 715-735-8016
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Fax | 715-732-8208
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Authorized Official
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Title or Position | ASSISTANT TREASURER
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Name | MRS. NAN NELSON
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Credential |
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Telephone | 414-299-1610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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