Gregg E Tetting, MD | |
200 E Ryan Rd, Oak Creek, WI 53154-4563 | |
(414) 570-3590 | |
Not Available |
Full Name | Gregg E Tetting |
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Gender | Male |
Speciality | Pediatrics |
Location | 200 E Ryan Rd, Oak Creek, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023196524 | NPI | - | NPPES |
32217600 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 37559-20 (Wisconsin) | Primary |
Entity Name | Aurora Medical Group, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Entity Name | Lakeshore Medical Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481 |
Entity Name | Aurora Advanced Healthcare Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265629133 PECOS PAC ID: 3375625833 Enrollment ID: O20080123000694 |
Mailing Address | Practice Location Address |
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Gregg E Tetting, MD Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Gregg E Tetting, MD 200 E Ryan Rd, Oak Creek, WI 53154-4563 Ph: (414) 570-3590 |
Mallory Hannah Salentine, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 8375 S Howell Ave, Oak Creek, WI 53154 Phone: 414-764-5726 Fax: 414-764-6954 | |
Angela M Bier, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 8375 S Howell Ave, Oak Creek, WI 53154 Phone: 414-764-5726 Fax: 414-164-6954 | |
Mr. David S. Ogren, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 8375 S Howell Ave, Oak Creek, WI 53154 Phone: 414-764-5726 Fax: 414-764-5726 | |
Smriti S Khare, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 8661 S Howell Ave, Oak Creek, WI 53154 Phone: 414-764-5726 Fax: 414-764-6954 | |
Randall Lee Fiete, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 980 E Twin Oaks Dr, Oak Creek, WI 53154 Phone: 414-571-9680 | |
Steven J Jereb, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 8661 S Howell Ave, Oak Creek, WI 53154 Phone: 414-764-5726 Fax: 414-764-6954 |