Family Practice Clinic Of Mayfair Sc | |
11803 W North Ave Wauwatosa WI 53226 | |
(414) 258-5522 | |
(414) 258-1337 |
Full Name | Family Practice Clinic Of Mayfair Sc |
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Speciality | General Practice |
Location | 11803 W North Ave, Wauwatosa, Wisconsin |
Authorized Official Name and Position | Marlene B Knie (OFFICE MANAGER) |
Authorized Official Contact | 4142585522 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Family Practice Clinic Of Mayfair Sc 11803 W North Ave Wauwatosa WI 53226 Ph: (414) 258-5522 | Family Practice Clinic Of Mayfair Sc 11803 W North Ave Wauwatosa WI 53226 Ph: (414) 258-5522 |
NPI Number | 1295810208 |
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Provider Enumeration Date | 10/26/2006 |
Last Update Date | 10/29/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295810208 | NPI | - | NPPES |
30074100 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
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