MEDICARE: DR. KARL ALEXANDER DAMROTH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	71809	MN
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	86217-20	WI

General Provider Information

NPI Number	:	1881125482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARL ALEXANDER DAMROTH M.D.

Provider Business Mailing Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-0001
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 S VAN BUREN ST STE 303
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54301-3534
Country	:	US
Telephone Number	:	920-433-9621
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2017
Last Update Date	:	08/27/2025

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