Organization · Type 2 NPI

Bellin Memorial Hospital Inc

Family Medicine Physician · Green Bay, WI

NPI number 1912420779 Active

Practice location

1630 Commanche Ave Ste 102
Green Bay, WI 54313-5753

Call (920) 430-4700 Map

Fax (920) 430-4747

Mailing address

PO Box 22487
Green Bay, WI 54305-2487

Other practice locations

440 Woodward Ave, Iron Mountain, MI 49801-4631 · (906) 776-9040

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

3 other providers at this address

Other family medicine physician providers in Green Bay

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NPI record

NPI: 1912420779
Entity type: Organization (Type 2)
Issued: Jul 24, 2017
Last updated: Jun 23, 2026
Status: Active
Subpart: Yes of Bellin Memorial Hospital Inc

Other names

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Bellin Health Ashwaubenon Urgent Care · doing business as
Bellin Health · doing business as

Authorized official

Abby Julia Engebose
Credentialing Specialist
(920) 433-7860

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1912420779

Bellin Memorial Hospital Inc's National Provider Identifier is 1912420779, issued on Jul 24, 2017. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Green Bay, WI. The record was last updated on Jun 23, 2026.