Organization
SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE, S.C.
Active
Other names
Southeastern Pediatric & Adolescent Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
ROSIE DELTORO (ASSISTANT OFFICE MANAGER)
(414) 463-2607
Entity
Organization
Contact information
Practice address
8532 W CAPITOL DR, MILWAUKEE, WI 53222-1848
(414) 463-2607
(414) 463-6743
Mailing address
8532 W CAPITOL DR, MILWAUKEE, WI 53222-1848
(414) 463-2607
(414) 463-6743
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32787700
—
WI
Enumeration date
03/12/2007
Last updated
04/30/2015
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