Organization
GREENDALE MEDICAL CLINIC, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY LUBING RN (OFFICE MANAGER)
(414) 423-0555
Entity
Organization
Contact information
Practice address
6601 NORTHWAY # D, GREENDALE, WI 53129-1830
(414) 423-0555
(414) 423-8268
Mailing address
6601 NORTHWAY # D, GREENDALE, WI 53129-1830
(414) 423-0555
(414) 423-8268
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32688400
—
WI
Enumeration date
09/26/2006
Last updated
08/22/2020
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