| Summit Medical Specialists, Sc | |
|
2717 N Grandview Blvd Ste 202 Waukesha WI 53188-1660 | |
| (262) 513-0700 | |
| (262) 513-0707 |
| Full Name | Summit Medical Specialists, Sc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2717 N Grandview Blvd Ste 202, Waukesha, Wisconsin |
| Authorized Official Name and Position | Tim Levenhagen (OWNER) |
| Authorized Official Contact | 2625130700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Medical Specialists, Sc 2717 N Grandview Blvd Ste 202 Waukesha WI 53188-1660 Ph: (262) 513-0700 | Summit Medical Specialists, Sc 2717 N Grandview Blvd Ste 202 Waukesha WI 53188-1660 Ph: (262) 513-0700 |
| NPI Number | 1053538843 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053538843 | NPI | - | NPPES |
| 32189000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 33398 (Wisconsin) | Primary |
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