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Organization
CARBON HEALTH MEDICAL GROUP OF WISCONSIN SC
Active
Organization
CARBON HEALTH MEDICAL GROUP OF WISCONSIN SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLEY PAGE (DIRECTOR)
(417) 861-9739
Entity
Organization
Contact information
Practice address
11415 W BURLEIGH ST STE 103, WAUWATOSA, WI 53222-3217
(844) 234-7741
Mailing address
2100 FRANKLIN ST STE 355, OAKLAND, CA 94612-3140
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
NULL
Other
Enumeration date
11/16/2022
Last updated
06/24/2025
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