National Provider Identifier Database

SHEBOYGAN MEDICAL CENTER LLC
Ambulatory Surgical


Contact Information

SHEBOYGAN MEDICAL CENTER, LLC
2124 KOHLER MEMORIAL DR
STE 100
SHEBOYGAN, WI53081
Phone: 920-452-7246
Fax: 920-452-7388
Website:
Specialty Taxonomy Code
* Ambulatory Surgical 261QA1903X

* Indicates primary specialty

NPI Profile & details for SHEBOYGAN MEDICAL CENTER, LLC

NPI Number 1366487241
Legal business name
LBN
SHEBOYGAN MEDICAL CENTER, LLC
Authorized official VISHAL LAL - (EXECUTIVE ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 06/17/2006
Last updated 10/24/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • WI Medicaid: 41914800

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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