Organization
FAMILY DOCTORS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SURESH K MISRA MD (OWNER)
(414) 643-7448
Entity
Organization
Contact information
Practice address
3267 S 16TH ST, SUITE 208, MILWAUKEE, WI 53215-4500
(414) 643-7448
(414) 643-7482
Mailing address
3267 S 16TH ST, SUITE 208, MILWAUKEE, WI 53215-4500
(414) 643-7448
(414) 643-7482
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21429
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21251200
—
WI
01
—
CH8008
RR MEDICARE
—
Enumeration date
07/06/2006
Last updated
10/24/2007
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