Dr Gregory J Boulanger, MD | |
2025 E Newport Ave, Milwaukee, WI 53211-2906 | |
(414) 961-3300 | |
Not Available |
Full Name | Dr Gregory J Boulanger |
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Gender | Male |
Speciality | Anesthesiology |
Location | 2025 E Newport Ave, Milwaukee, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184607160 | NPI | - | NPPES |
31782800 | Medicaid | WI | |
P00385324 | Other | RAIL ROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 24468-020 (Wisconsin) | Primary |
Entity Name | Columbia St Marys Hospital Milwaukee Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073832218 PECOS PAC ID: 5890604722 Enrollment ID: O20101101000597 |
Mailing Address | Practice Location Address |
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Dr Gregory J Boulanger, MD 225 S Executive Dr, Brookfield, WI 53005-4266 Ph: (262) 787-4026 | Dr Gregory J Boulanger, MD 2025 E Newport Ave, Milwaukee, WI 53211-2906 Ph: (414) 961-3300 |
Dr. Jeffrey T Lyvers, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2900 W Oklahoma Ave, Milwaukee, WI 53215 Phone: 414-649-6000 | |
Dr. Nosheen Hasan, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 7235 W Appleton Ave, Sutie 102, Milwaukee, WI 53216 Phone: 414-444-8670 Fax: 414-444-8678 | |
Dr. Quinn Hogan, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 9200 W Wisconsin Ave, Department Of Anesthesiology, Milwaukee, WI 53226 Phone: 414-805-8700 Fax: 414-259-1522 | |
Dr. Stephen R Thompson, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 2025 E Newport Ave, Milwaukee, WI 53211 Phone: 414-961-3300 | |
Dr. Christina D Diaz, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 9200 W Wisconsin Ave, Department Of Anesthesiology, Milwaukee, WI 53226 Phone: 414-805-8700 Fax: 414-259-1522 | |
Dr. John V Selthafner, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 414-805-8700 Fax: 414-259-1522 | |
Anne M Fagan, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 10200 W Innovation Dr, Milwaukee, WI 53226 Phone: 414-302-9196 |