# FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780142992
- **Legal business name:** FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS
- **Authorized official:** RANDALL NEWMAN (VP OF FINANCE)
- **Authorized official phone:** (414) 777-7963

## Contact information

- **Practice address:** 11040 N RANGE LINE RD, MEQUON, WI 53092-4930
- **Practice address phone:** (262) 253-5230
- **Mailing address:** 11040 N RANGE LINE RD, MEQUON, WI 53092-4930
- **Mailing address phone:** (262) 253-5230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 03/06/2019
- **Last updated:** 03/06/2019