Organization
ASCENSION MEDICAL GROUP-SOUTHEAST WISCONSIN INC
Active
Other names
AMG Anesthesia
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN FISSEL (VP-FINANCE)
(414) 465-3000
Entity
Organization
Contact information
Practice address
2301 N LAKE DR, MILWAUKEE, WI 53211-4508
(414) 585-1000
Mailing address
400 W RIVER WOODS PKWY, GLENDALE, WI 53212-1060
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
03/10/2022
Last updated
03/21/2023
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