# CHARLES J. WAISBREN MD S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447302492
- **Authorized official:** DR. CHARLES J WAISBREN MD S.C. (PHYSICIAN)
- **Authorized official phone:** (414) 771-5900

## Contact information

- **Practice address:** 3077 N MAYFAIR RD, SUITE 100, WAUWATOSA, WI 53222-4305
- **Practice address phone:** (414) 771-5900
- **Practice address fax:** (414) 771-4908
- **Mailing address:** 3077 N MAYFAIR RD, SUITE 100, WAUWATOSA, WI 53222-4305
- **Mailing address phone:** (414) 771-5900
- **Mailing address fax:** (414) 771-4908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 25111 | WI | Yes |

## Other

- **Enumeration date:** 01/18/2007
- **Last updated:** 03/07/2023