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Organization
MAPLE MEDICAL SC
Active
Organization
MAPLE MEDICAL SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARRY HOSTETLER MD (OWNER)
(262) 875-5070
Entity
Organization
Contact information
Practice address
2428 N GRANDVIEW BLVD STE 102, WAUKESHA, WI 53188-6906
(877) 307-3226
(877) 307-3226
Mailing address
PO BOX 474, HARTLAND, WI 53029-0474
(877) 307-3226
(866) 384-9486
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
Other
Enumeration date
01/28/2018
Last updated
10/07/2026
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