Organization
CHARLES J. WAISBREN MD S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES J WAISBREN MD S.C. (PHYSICIAN)
(414) 771-5900
Entity
Organization
Contact information
Practice address
3077 N MAYFAIR RD, SUITE 100, WAUWATOSA, WI 53222-4305
(414) 771-5900
(414) 771-4908
Mailing address
3077 N MAYFAIR RD, SUITE 100, WAUWATOSA, WI 53222-4305
(414) 771-5900
(414) 771-4908
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25111
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750481206
PERSONAL NPI #
WI
Enumeration date
01/18/2007
Last updated
03/07/2023
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