Organization
OAK MEDICAL SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHTAB SIDHU M.D. (MEDICAL DIRECTOR)
(262) 875-5070
Entity
Organization
Contact information
Practice address
2428 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6906
(262) 875-5070
Mailing address
PO BOX 474, HARTLAND, WI 53029-0474
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
02/02/2017
Last updated
09/11/2023
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