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Organization

PEDIATRIC EAR, NOSE & THROAT SPECIALISTS SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID J BESTE M.D. (PRESIDENT)
(414) 266-2761
Entity
Organization

Contact information

Practice address
9000 W WISCONSIN AVE, SUITE 265, MILWAUKEE, WI 53226-3518
(414) 266-2761
(414) 266-2766
Mailing address
9000 W WISCONSIN AVE, SUITE 265, MILWAUKEE, WI 53226-3518
(414) 266-2761
(414) 266-2766

Taxonomy

Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
22968
WI
207YP0228X
Pediatric Otolaryngology Physician
43113
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30581400
WI
05
34060600
WI
Enumeration date
02/16/2007
Last updated
05/30/2012
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