Organization
WISCONSIN HEART GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID L. GRODEN M.D. (M.D. & PRESIDENT)
(262) 827-9200
Entity
Organization
Contact information
Practice address
16650 W BLUEMOUND RD, SUITE 200, BROOKFIELD, WI 53005-5920
(262) 827-9200
(262) 827-9858
Mailing address
16650 W BLUEMOUND RD, SUITE 200, BROOKFIELD, WI 53005-5920
(262) 827-9200
(262) 827-9858
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32678600
—
WI
Enumeration date
06/04/2006
Last updated
09/15/2015
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