Dr Mark A Clemence, MD | |
6080 S 108th St, Hales Corners, WI 53130-2557 | |
(414) 425-5351 | |
(414) 529-6350 |
Full Name | Dr Mark A Clemence |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Experience | 38 Years |
Location | 6080 S 108th St, Hales Corners, Wisconsin |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255324216 | NPI | - | NPPES |
045668480 | Other | WI | MEDICARE PTAN |
049873840 | Other | WI | MEDICARE PTAN |
32081200 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 34043 (Wisconsin) | Primary |
207RI0200X | Internal Medicine - Infectious Disease | 34043 (Wisconsin) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Ascension At Home | Milwaukee, WI | Home health agency |
Aurora At Home | Milwaukee, WI | Home health agency |
Ascension Se Wisconsin Hospital - St Joseph Campus | Milwaukee, WI | Hospital |
Ascension St Francis Hospital | Milwaukee, WI | Hospital |
Ascension Columbia St Mary's Hospital Milwaukee | Milwaukee, WI | Hospital |
West Allis Memorial Hospital | West allis, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Wheaton Franciscan Medical Group Inc | 8628980943 | 565 |
Entity Name | Ascension Medical Group-southeast Wisconsin Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609881077 PECOS PAC ID: 8628980943 Enrollment ID: O20031104000421 |
Mailing Address | Practice Location Address |
---|---|
Dr Mark A Clemence, MD Po Box 689711, Milwaukee, WI 53268-9711 Ph: (414) 456-3100 | Dr Mark A Clemence, MD 6080 S 108th St, Hales Corners, WI 53130-2557 Ph: (414) 425-5351 |