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Organization
PEDIATRIX MEDICAL GROUP OF WISCONSIN, SC
Active
Organization
PEDIATRIX MEDICAL GROUP OF WISCONSIN, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DELORES M GRIES MD (DIRECTOR, PRESIDENT)
(800) 243-3839
Entity
Organization
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2000
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(800) 243-3839
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
363LN0000X
Neonatal Nurse Practitioner
—
—
Other
Enumeration date
12/21/2022
Last updated
12/21/2022
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