Organization
OZAUKEE MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE C HERMAN M.D. (MANAGER)
(262) 242-3000
Entity
Organization
Contact information
Practice address
407 N MAIN ST, THIENSVILLE, WI 53092-1212
(262) 242-3000
(262) 242-7191
Mailing address
407 N MAIN ST, THIENSVILLE, WI 53092-1212
(262) 242-3000
(262) 242-7191
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21717
WI
Other
Enumeration date
11/01/2006
Last updated
10/11/2010
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