Organization
GREATER MILWAUKEE PLASTIC SURGEONS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM MARK MENZEL MBA (BUSINESS MANAGER)
(262) 717-4030
Entity
Organization
Contact information
Practice address
13800 W NORTH AVENUE, SUITE 110, BROOKFIELD, WI 53005
(262) 717-4000
(262) 641-7435
Mailing address
13800 W NORTH AVENUE, SUITE 110, BROOKFIELD, WI 53005
(262) 717-4000
(262) 641-7435
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32836200
—
WI
Enumeration date
05/03/2006
Last updated
05/09/2008
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