Organization
MARTIN MEN'S MEDICAL CLINIC OF WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MOELLER (CLINIC DIRECTOR)
(414) 454-6000
Entity
Organization
Contact information
Practice address
2949 N MAYFAIR RD STE 300, WAUWATOSA, WI 53222-4304
(414) 454-6000
(414) 454-6420
Mailing address
2949 N MAYFAIR RD STE 300, WAUWATOSA, WI 53222-4304
(414) 454-6000
(414) 454-6420
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
20798-020
WI
Other
Enumeration date
09/22/2009
Last updated
09/22/2009
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