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Organization
SOUTHEASTERN PEDIATRICS, SC
Active
Organization
SOUTHEASTERN PEDIATRICS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RATIDZAI RIOGA MD (PRESIDENT)
(414) 771-0500
Entity
Organization
Contact information
Practice address
10625 W NORTH AVE STE 326, WAUWATOSA, WI 53226-2315
(414) 771-0500
(414) 771-0363
Mailing address
7592 SOLUTIONS CTR # 777592, CHICAGO, IL 60677-7005
(262) 641-3700
(262) 641-3719
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41265
WI
2080A0000X
Pediatric Adolescent Medicine Physician
41265
WI
Other
Enumeration date
04/17/2013
Last updated
05/15/2024
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