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General NPI Number Information
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NPI Number | 1396707089
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Entity Type | Organization
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Legal Business Name | BELLIN MEMORIAL HOSPITAL INC
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 10/18/2021
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Provider Practice Location Address
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Address Line | 1630 COMMANCHE AVE
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City | GREEN BAY
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State | WI
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Zip | 54313-6089
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Country | US
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Telephone | 920-497-7771
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Fax |
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Provider Business Mailing Address
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Address Line | 1630 COMMANCHE AVE
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City | GREEN BAY
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State | WI
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Zip | 54313-6089
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Country | US
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Telephone | 920-497-7771
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | DENISE K STROOBANTS
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Credential |
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Telephone | 920-433-7864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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