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Contact Information

PREVEA CLINIC, INC.
2710 EXECUTIVE DR
GREEN BAY, WI54304-5496
 Phone: 920-496-4700
 Fax: 920-496-4705
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Allergy & Immunology

207K00000X 03 Physician/Allergy/ Immunology
 

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
 

Gynecologic Oncology

207VX0201X 16 Physician/Obstetrics & Gynecology
 

Infectious Disease

207RI0200X 11 Physician/Internal Medicine
 

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
 

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Pediatric Allergy/Immunology

2080P0201X 37 Physician/Pediatric Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PREVEA CLINIC INC · (Female)

NPI Number 1306869276
Status Active
Credentials
Entity Individual
Enumeration date 07/25/2006
Last updated 01/12/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers
  • WI Medicaid 32704600
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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