| Mayville Family Practice Llc | |
|
5595 County Road Z West Bend WI 53095-9224 | |
| (262) 339-3038 | |
| Not Available |
| Full Name | Mayville Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5595 County Road Z, West Bend, Wisconsin |
| Authorized Official Name and Position | Charles Edward Sammis (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2623393033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mayville Family Practice Llc 3545 Martha Ct West Bend WI 53095-8792 Ph: (262) 339-3033 | Mayville Family Practice Llc 5595 County Road Z West Bend WI 53095-9224 Ph: (262) 339-3038 |
| NPI Number | 1154821387 |
|---|---|
| Provider Enumeration Date | 02/14/2018 |
| Last Update Date | 08/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154821387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 48218-21 (Wisconsin) | Primary |
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