Organization
THE MEDICAL COLLEGE OF WISCONSIN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH C MACE (DEPARTMENT ADMINISTRATOR)
(414) 456-8745
Entity
Organization
Contact information
Practice address
8701 W WATERTOWN PLANK RD, FAMILY MEDICINE-CCN BUILDING, MILWAUKEE, WI 53226-3548
(414) 955-8368
(414) 955-6523
Mailing address
8701 W WATERTOWN PLANK RD, FAMILY MEDICINE-CCN BUILDING, MILWAUKEE, WI 53226-3548
(414) 955-8368
(414) 955-6523
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100024243
—
WI
Enumeration date
09/25/2012
Last updated
09/25/2012
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