Organization
MAYVILLE FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES EDWARD SAMMIS DO (PHYSICIAN/OWNER)
(262) 339-3033
Entity
Organization
Contact information
Practice address
5595 COUNTY ROAD Z, WEST BEND, WI 53095-9224
(262) 339-3038
Mailing address
3545 MARTHA CT, WEST BEND, WI 53095-8792
(262) 339-3033
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
48218-21
WI
Other
Enumeration date
02/14/2018
Last updated
08/25/2021
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