Groenewold, Sandra

Groenewold, Sandra is an individual health care provider with primary practice located at 1095 Midway Rd , Menasha WI 54952-1115. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Groenewold, Sandra can be contacted via phone (920) 720-2300.

Contact Information

Primary practice address
1095 Midway Rd Menasha WI 54952-1115
Phone: (920) 720-2300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 36918 Wisconsin
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 36918 Wisconsin

Profile Details

NPI number 1881620722
LBN Legal business name Groenewold, Sandra
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Aug 4th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881620722 NPPES
Wisconsin MEDICAID 32309500

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