Organization
EMERGENCY MEDICINE SPECIALISTS, S.C.
Active
Other names
Emergency Medicine Specialists, S.C.
Organization subpart
No
Provider details
NPI number
Authorized official
CORY A WILSON (MANAGER)
(414) 858-2216
Entity
Organization
Contact information
Practice address
10625 W NORTH AVE, SUITE 102, MILWAUKEE, WI 53226-2315
(414) 877-5350
(414) 877-5360
Mailing address
10625 W NORTH AVE, SUITE 102, MILWAUKEE, WI 53226-2315
(414) 877-5350
(414) 877-5360
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01930
MEDICARE PTAN
WI
05
—
32704200
—
WI
Enumeration date
05/15/2006
Last updated
05/05/2017
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