Organization
TRANSPLANT S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH FAIRCHILD III M.D. (PHYSICIAN/OWNER)
(920) 457-6750
Entity
Organization
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY, #511, MILWAUKEE, WI 53215-3677
(414) 649-3780
(414) 649-3794
Mailing address
PO BOX 1127, SHEBOYGAN, WI 53082-1127
(920) 457-6750
(920) 457-8350
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0102X
Surgical Critical Care Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21281100
—
WI
Enumeration date
03/22/2006
Last updated
05/20/2008
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