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1720009459
PAUL R SUMMERSIDE
GREEN BAY, WI
NPI
1720009459
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: WI 29836)
Enumeration Date
2006-07-21
Last Update Date
2016-02-09
Business Address
-- PAUL R SUMMERSIDE MD
2253 W MASON ST
GREEN BAY, WI 54303-4706
Phone number: 920-327-7250
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Mailing Address
-- PAUL R SUMMERSIDE MD
614 RANDALL AVE
DE PERE, WI 54115-2640
Phone number: 920-327-7250
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