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Organization

WAUKESHA COUNTY

Active
Other names
Waukesha County (MHC Inpatient Dr)
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID M DEROSIER (CREDENTIALING SPECIALIST)
(262) 548-8431
Entity
Organization

Contact information

Practice address
1501 AIRPORT RD, WAUKESHA, WI 53188-3632
(262) 548-7950
(262) 970-4791
Mailing address
514 RIVERVIEW AVE, ATTN: FISCAL DEPARTMENT, WAUKESHA, WI 53188-3632
(262) 548-7399
(262) 970-6696

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
907
WI
174400000X
Specialist
907
WI
207L00000X
Anesthesiology Physician
907
WI
207LP2900X
Pain Medicine (Anesthesiology) Physician
907
WI
207Q00000X
Family Medicine Physician
907
WI
2084P0800X
Psychiatry Physician
Primary
907
WI

Other

Enumeration date
04/12/2007
Last updated
11/10/2025
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