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Organization
NORTH SHORE INTERNAL MEDICINE SPECIALIST, SC
Active
Organization
NORTH SHORE INTERNAL MEDICINE SPECIALIST, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEHRAN EDALATPOUR MD (PRESIDENT)
(262) 242-3369
Entity
Organization
Contact information
Practice address
140 S MAIN ST, THIENSVILLE, WI 53092-1956
(262) 242-3369
(262) 242-3219
Mailing address
6400 INDUSTRIAL LOOP, GREENDALE, WI 53129-2452
(414) 423-4100
(414) 423-4134
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
NULL
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
03/03/2008
Last updated
03/14/2008
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