OrganizationActive
Beaver Dam Community Hospitals, Inc
NPI 1023310034 · Sports Medicine (Family Medicine) Physician · Beaver Dam, WI
Provider details
- NPI number
- 1023310034
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Marshfield Clinic Health System Inc
- Organization subpart
- Yes
- Authorized official
- Gordon Edwards, Cfo/Coo/Ao(715) 387-5823
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
705 S University Ave Ste 150
Beaver Dam, WI 53916
Phone: (920) 219-4009
Fax: (920) 219-9709
Approximate (ZIP-level) locationGet directions
Mailing address
1000 N Oak Ave
Marshfield, WI 54449-5703
Other names (DBA / former)
- Doing business as
- (inactive) Mmc - Beaver Dam - Movement & Ortho, Rehab, Pt/Ot/St
Registry dates
- Enumerated
- 2010-11-23
- Last updated
- 2022-03-02
- Certified
- 2022-03-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.