Provider Demographics
NPI:1043699036
Name:UROLOGY ASSOCIATES OF GREEN BAY, SC
Entity type:Organization
Organization Name:UROLOGY ASSOCIATES OF GREEN BAY, SC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / UROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:920-433-9400
Mailing Address - Street 1:1385 W MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-9366
Mailing Address - Country:US
Mailing Address - Phone:920-433-9400
Mailing Address - Fax:920-433-9409
Practice Address - Street 1:2720 CAHILL RD
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-3892
Practice Address - Country:US
Practice Address - Phone:715-732-3420
Practice Address - Fax:715-732-3425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100043990Medicaid
WI000007235Medicare PIN