Organization
CSM COMMUNITY PHYSICIAN
Active
Parent organization
COLUMBIA ST MARYS HOSPITAL MILWAUKEE INC
Other names
CSMCP Cardiac Rhythm Specialist
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLUMBIA ST MARYS HOSPITAL MILWAUKEE INC
Authorized official
MS. DEBORAH E BJORN (PRACTICE ADMINISTRATOR)
(414) 298-7284
Entity
Organization
Contact information
Practice address
2700 W 9TH AVE, SUITE 106, OSHKOSH, WI 54904-7247
(414) 298-7280
(414) 298-7281
Mailing address
PO BOX 78309, MILWAUKEE, WI 53278-0001
(414) 298-7280
(414) 298-7281
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32793800
—
WI
Enumeration date
01/25/2010
Last updated
11/24/2010
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