Organization
THE MEDICAL COLLEGE OF WISCONSIN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW LESTER MBA, MHA, CPA (EXECUTIVE VICE PRESIDENT FINANCE)
(414) 955-8704
Entity
Organization
Contact information
Practice address
1155 N MAYFAIR RD, MILWAUKEE, WI 53226-3421
(414) 955-5990
Mailing address
10000 W INNOVATION DR, SUITE 300, MILWAUKEE, WI 53226-4837
(414) 955-5006
(414) 955-6079
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
122300000X
Dentist
—
—
152W00000X
Optometrist
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
204F00000X
Transplant Surgery Physician
—
—
207K00000X
Allergy & Immunology Physician
—
—
207L00000X
Anesthesiology Physician
—
—
207N00000X
Dermatology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207T00000X
Neurological Surgery Physician
—
—
208600000X
Surgery Physician
—
—
291U00000X
Clinical Medical Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699720086
—
WI
05
—
32730400
—
WI
05
—
32739000
—
WI
05
—
38381400
—
WI
05
—
41170800
—
WI
Enumeration date
05/23/2006
Last updated
03/27/2023
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