Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. GORDON GLENN ROEDEL, MD
ActiveDR. GORDON GLENN ROEDEL, MD is a Sports Medicine (Orthopaedic) healthcare provider located in GREEN BAY, Wisconsin. NPI 1851812937 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (Orthopaedic) · GREEN BAY, WI
Registration Details
- NPI Number
- 1851812937
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 29, 2017 (9.1725058064101 yrs)
- Last Updated
- Aug 18, 2023
- Licenses
-
8109 (NE)82150 (WI)
Practice Information
- Address
-
2223 LIME KILN RD STE 1GREEN BAY, WI, 543116213Browse WI providers · Browse ZIP 54311
- Phone
- 9204308113
- Fax
- 9204308122
- Primary Specialty
-
Sports Medicine (Orthopaedic)
207XS0114X
- Additional Specialty
- Sports Medicine (Orthopaedic)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.