| Southeastern Pediatrics, Sc | |
|
10625 W North Ave Ste 326 Wauwatosa WI 53226-2315 | |
| (414) 771-0500 | |
| (414) 771-0363 |
| Full Name | Southeastern Pediatrics, Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 10625 W North Ave Ste 326, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Ratidzai Rioga (PRESIDENT) |
| Authorized Official Contact | 4147710500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeastern Pediatrics, Sc 7592 Solutions Ctr # 777592 Chicago IL 60677-7005 Ph: (262) 641-3700 | Southeastern Pediatrics, Sc 10625 W North Ave Ste 326 Wauwatosa WI 53226-2315 Ph: (414) 771-0500 |
| NPI Number | 1154765410 |
|---|---|
| Provider Enumeration Date | 04/17/2013 |
| Last Update Date | 05/15/2024 |
| Medicare PECOS PAC ID | 1850667114 |
|---|---|
| Medicare Enrollment ID | O20171101000917 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154765410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 41265 (Wisconsin) | Primary |
| 2080A0000X | Pediatrics - Adolescent Medicine | 41265 (Wisconsin) | Secondary |
| Provider Name | Ratidzai Rioga |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437215001 PECOS PAC ID: 8628205309 Enrollment ID: I20171101001067 |
Wisconsin Healthcare Family Practices And Behavioral Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10721 W Capitol Dr Ste G103, Wauwatosa, WI 53222 Phone: 414-219-9420 Fax: 414-909-8674 | |
Carbon Health Primary Care Of Wisconsin Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11415 W Burleigh St Ste 103, Wauwatosa, WI 53222 Phone: 415-446-1733 | |
Martin Men's Medical Clinic Of Wisconsin Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2949 N Mayfair Rd Ste 300, Wauwatosa, WI 53222 Phone: 414-454-6000 Fax: 414-454-6420 | |
Numale Medical Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 N Mayfair Rd, Suite 505, Wauwatosa, WI 53226 Phone: 414-727-8380 Fax: 414-727-8555 | |
Family Practice Clinic Of Mayfair Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11803 W North Ave, Wauwatosa, WI 53226 Phone: 414-258-5522 Fax: 414-258-1337 | |
Cmm Sundaram Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 N Mayfair Rd, Suite 670, Wauwatosa, WI 53226 Phone: 414-933-9851 |