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Organization

CHILDREN'S MEDICAL GROUP, INC.

Active
Parent organization
CHILDREN'S MEDICAL GROUP
Other names
Delafield Pediatrics
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHILDREN'S MEDICAL GROUP
Authorized official
SMRITI KHARE M.D. (PRESIDENT, CHILDREN'S MEDICAL GROUP)
(414) 266-7615
Entity
Organization

Contact information

Practice address
3195 HILLSIDE DRIVE, DELAFIELD, WI 53018-2189
(262) 646-9960
(262) 646-9961
Mailing address
9000 W WISCONSIN AVE, MAIL STATION 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1710389473
WI
Enumeration date
09/24/2014
Last updated
11/23/2015
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