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Organization

FROEDTERT & MEDICAL COLLEGE OF WI COMMUNITY PHYSICIANS

Active
Parent organization
FROEDTERT & MEDICAL COLLEGE OF WI COMMUNITY PHYSICIANS
Organization subpart
Yes

Provider details

NPI number
Legal business name
FROEDTERT & MEDICAL COLLEGE OF WI COMMUNITY PHYSICIANS
Authorized official
RANDALL NEWMAN (VP FINANCE)
(414) 777-7963
Entity
Organization

Contact information

Practice address
1700 PARADISE DR, WEST BEND, WI 53095-9795
(262) 253-5230
Mailing address
1700 PARADISE DR, WEST BEND, WI 53095-9795

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary

Other

Enumeration date
06/23/2020
Last updated
06/23/2020
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