EDWARD JOHN BANTAMOI

GREEN BAY, WI
NPI1457376758
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: WI  48796)
Enumeration Date2006-07-13
Last Update Date2017-09-18
Business Address
-- EDWARD JOHN BANTAMOI MD
2502 S. ASHLAND AVE.
GREEN BAY, WI 54304
Phone number: 920-496-4700
Mailing Address
-- EDWARD JOHN BANTAMOI MD
PO BOX 19070
GREEN BAY, WI 54307-9070
Phone number: 920-496-4700
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