Organization
CARDIOTHORACIC SURGERY GROUP SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT P MCMANUS MD (PRESIDENT)
(414) 271-5119
Entity
Organization
Contact information
Practice address
2315 N LAKE DR, MILWAUKEE, WI 53211-4516
(414) 271-5119
(414) 271-3756
Mailing address
2315 N LAKE DR, MILWAUKEE, WI 53211-4516
(414) 271-5119
(414) 271-3756
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32895200
—
WI
Enumeration date
03/02/2006
Last updated
08/22/2020
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