Organization
GS MICELI DPM, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GIUSEPPE S MICELI D.P.M. (OWNER)
(262) 925-6565
Entity
Organization
Contact information
Practice address
7201 GREEN BAY RD, SUITE A, KENOSHA, WI 53142-3532
(262) 925-6565
(262) 697-4291
Mailing address
PO BOX 580149, PLEASANT PRAIRIE, WI 53158-8011
(262) 925-6565
(262) 697-4291
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
524
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43208700
—
WI
Enumeration date
11/13/2006
Last updated
04/22/2008
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