| Faculty Physicians Of Internal Medicine, S.c. | |
|
2801 W Kinnickinnic River Pkwy Suite 730 Milwaukee WI 53215-3669 | |
| (414) 649-7202 | |
| (414) 649-5158 |
| Full Name | Faculty Physicians Of Internal Medicine, S.c. |
|---|---|
| Speciality | Clinical Medical Laboratory |
| Location | 2801 W Kinnickinnic River Pkwy, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Colleen M Nichols (PRESIDENT) |
| Authorized Official Contact | 4146497202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Faculty Physicians Of Internal Medicine, S.c. 2801 W Kinnickinnic River Pkwy Suite 730 Milwaukee WI 53215-3669 Ph: (414) 649-7202 | Faculty Physicians Of Internal Medicine, S.c. 2801 W Kinnickinnic River Pkwy Suite 730 Milwaukee WI 53215-3669 Ph: (414) 649-7202 |
| NPI Number | 1831173699 |
|---|---|
| Provider Enumeration Date | 12/05/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831173699 | NPI | - | NPPES |
| 29288 | Other | WI | RAILROAD MEDICARE |
| 21254500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Wisconsin) | Primary |
| 291U00000X | Clinical Medical Laboratory | (Wisconsin) | Primary |
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