GREGORY M GREWE (NPI# 1306871769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306871769 |
| Entity Type | Individual |
| Full Name | GREGORY M GREWE |
| Credential | MD |
| Practice Address |
1789 Shawano Ave Green Bay WI 54303 |
| Mailing Address |
1789 Shawano Ave Green Bay WI 54303-3243 |
| Practice Telephone | 9204991428 |
| Practice Fax Number | 9204995808 |
| Mailing Telephone | 9204991428 |
| Mailing Fax Number | 9204995808 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2017-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
30051-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4838153 | 05 | |
| UNITED HEALTHCARE AMERICH | 1018806004 | 01 | |
| RR MEDICARE | P00287110 | 01 | |
| WI | 31476800 | 05 | |
| MI | 4838144 | 05 |
| Street Address |
1789 SHAWANO AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144206814 | Jeff C Arnholt | Radiology | 1789 Shawano Ave, Radiology Chartered, Green Bay, WI 54303-3243 | 2005-12-15 |
| 1275791832 | Riley A Smyth | Radiology | 1789 Shawano Ave, Green Bay, WI 54303-3243 | 2008-05-29 |
| 1508046418 | Jesse Jon Borman | Radiology | 1789 Shawano Ave, Green Bay, WI 54303-3243 | 2007-11-08 |
| 1487755344 | Dannel Vernon Wielgus | Dentist | 1789 Shawano Ave, Green Bay, WI 54303-3243 | 2006-09-25 |
| 1275551160 | Bela R. Ballo | Radiology | 1789 Shawano Ave, Green Bay, WI 54303-3243 | 2006-07-18 |
| 1215962675 | Robert J Monette | Radiology | 1789 Shawano Ave, Green Bay, WI 54303-3243 | 2006-07-12 |
| 1124053582 | Michael A Ross | Radiology | 1789 Shawano Ave, Green Bay, WI 54303 | 2006-07-12 |
| 1063447423 | Patrick M Carrigan | Radiology | 1789 Shawano Ave, Green Bay, WI 54303 | 2006-07-12 |
| 1760416895 | Radiology Chartered | Radiology | 1789 Shawano Ave, Green Bay, WI 54303-3243 | 2006-07-11 |
| 1912932054 | Douglas J Coyle | Radiology | 1789 Shawano Ave, Green Bay, WI 54303 | 2006-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043256159 | William L Hingtgen | Radiology | 1789 Shawano, Green Bay, WI 54303 | 2006-06-20 |
| 1033172390 | Bellin Memorial Hospital Inc | Radiology | 1580 Commanche Ave Ste 102, Green Bay, WI 54313-5751 | 2006-04-08 |
| 1033187927 | Jeremy Boone Mccue | Radiology | 2941 S Ridge Rd, Green Bay, WI 54304-5517 | 2006-03-08 |
| 1144206814 | Jeff C Arnholt | Radiology | 1789 Shawano Ave, Radiology Chartered, Green Bay, WI 54303-3243 | 2005-12-15 |
| 1497198022 | Kristin E Joachim | Radiology | 2941 S Ridge Rd, Green Bay, WI 54304-5517 | 2013-04-13 |
| 1255698221 | Mark Andrew Welnick | Radiology | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2012-04-16 |
| 1669738043 | Frederick George Joachim IIi | Radiology | 2941 S Ridge Rd, Green Bay, WI 54304 | 2012-04-10 |
| 1811263304 | Brandon Charles Bodager | Radiology | 2941 S Ridge Rd, Green Bay, WI 54304 | 2012-03-28 |
| 1447480256 | Tyler J Bailey | Radiology | 2941 S Ridge Rd, Green Bay, WI 54304-5517 | 2009-07-15 |
| 1710142237 | Jordan Elizabeth Toman | Radiology | 164 N Broadway, Green Bay, WI 54303-2728 | 2008-07-24 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.