| West Bend Pediatrics | |
|
611 Veterans Ave Ste 106 West Bend WI 53090-2545 | |
| (262) 353-4460 | |
| (262) 353-4461 |
| Full Name | West Bend Pediatrics |
|---|---|
| Speciality | Pediatrics |
| Location | 611 Veterans Ave Ste 106, West Bend, Wisconsin |
| Authorized Official Name and Position | Smriti Khare (PRESIDENT-CHILDREN'S MEDICAL GROUP) |
| Authorized Official Contact | 4142667615 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Bend Pediatrics 9000 W Wisconsin Ave Ms 958 Milwaukee WI 53226-4874 Ph: (414) 266-7615 | West Bend Pediatrics 611 Veterans Ave Ste 106 West Bend WI 53090-2545 Ph: (262) 353-4460 |
| NPI Number | 1992171987 |
|---|---|
| Provider Enumeration Date | 08/13/2015 |
| Last Update Date | 09/27/2021 |
| Certification Date | 09/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992171987 | NPI | - | NPPES |
| 1992171987 | Medicaid | WI |
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