Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Beaver Dam Community Hospitals Inc

Organization Family Medicine Physician · NPI 1629374780

Beaver Dam Community Hospitals Inc provides Family Medicine Physician services in Waupun, Wisconsin. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

180 Gateway Dr
Waupun, WI 53963
Phone: (920) 345-1306
Fax: (920) 345-1325
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1629374780
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMarshfield Clinic Health System Inc
Authorized official Gordon Edwards — Cfo/Coo/Ao · (715) 387-5823
Other names Inactive) Marshfield Medical Center - Beaver Dam Waupun Center (Hopd
NPI enumeratedFebruary 7, 2011
Last updated in NPPESMarch 3, 2022
Certification dateMarch 3, 2022
Mailing address1000 N Oak Ave, Attn: Provider Enrollment Services/Wwp, Marshfield, WI 54449-5703

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