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Organization

EDWARD WOLPERT MD SC LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWARD A WOLPERT MD PHD (PRESIDENT)
(608) 588-7173
Entity
Organization

Contact information

Practice address
156 W JEFFERSON, SPRING GREEN, WI 53588
(608) 588-2600
(608) 588-2644
Mailing address
E7560 TROY VILLAGE RD., SPRING GREEN, WI 53588
(608) 588-2600
(608) 588-2644

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071002659
IL
2084P0800X
Psychiatry Physician
03637375
IL
2084P0800X
Psychiatry Physician
Primary
18657020
WI

Other

Enumeration date
12/03/2008
Last updated
02/13/2009
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