GBR SHEBOYGAN LLC NPI 1467529917

NPI Information

  • NPI: 1467529917
  • Provider Name: GBR SHEBOYGAN LLC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Address: 3100 SUPERIOR AVE
    SHEBOYGAN, WI
    ZIP 53081
  • Phone: (920) 964-0480

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NPI Details

GBR SHEBOYGAN LLC is a diagnostic radiology radiology in Sheboygan, WI. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. GBR SHEBOYGAN LLC NPI is 1467529917. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3100 SUPERIOR AVE
SHEBOYGAN, WI
ZIP 53081-948
Phone: (920) 964-0480
Fax: (920) 336-8093

The provider's authorized official is Jimmy Dado .
The authorized official title is Authorized Offical and has the following contact phone number (614) 325-8899.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 3/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyWISCONSINYes
22085R0204XRadiologyVascular & Interventional RadiologyWISCONSINNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
121284500MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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