| NPI | 1265629133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAN NELSON CFO 414-299-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 207N00000X Dermatology | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 207W00000X Ophthalmology | |
| 207X00000X Orthopaedic Surgery | |
| 207Y00000X Otolaryngology | |
| 208000000X Pediatrics | |
| 208600000X Surgery | |
| 208800000X Urology | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2023-09-11 |