Organization
MCMC URGICARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SYED GOUSE MOHIUDDIN MD (DEDICAL DIRECTOR)
(414) 431-5004
Entity
Organization
Contact information
Practice address
5310 W CAPITOL DR, 101, MILWAUKEE, WI 53216-2263
(414) 431-5004
(414) 431-2959
Mailing address
5310 W CAPITOL DR, 101, MILWAUKEE, WI 53216-2263
(414) 431-5004
(414) 431-2959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21270100
—
WI
Enumeration date
08/30/2006
Last updated
08/22/2020
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