Organization
MILWAUKEE UROLOGICAL SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA HENDERSON (OFFICE MANAGER)
(414) 961-7323
Entity
Organization
Contact information
Practice address
2015 E NEWPORT AVE, SUITE 500, MILWAUKEE, WI 53211-2984
(414) 961-7323
(414) 964-6445
Mailing address
2015 E NEWPORT AVE, SUITE 500, MILWAUKEE, WI 53211-2984
(414) 961-7323
(414) 964-6445
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396732806
NPI
WI
01
—
1710975289
NPI
WI
01
—
1891788113
NPI
WI
05
—
32009700
—
WI
05
—
32675600
—
WI
Enumeration date
06/13/2007
Last updated
08/22/2020
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