Organization
RADIOLOGY WAUKESHA S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFFREY MATTHEW FETE M.D. (PRESIDENT)
(262) 928-2400
Entity
Organization
Contact information
Practice address
725 AMERICAN AVE, WAUKESHA, WI 53188-5031
(262) 928-2400
(262) 928-7621
Mailing address
PO BOX 1790, BROOKFIELD, WI 53008-1790
(262) 641-9411
(262) 641-6893
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32727700
—
WI
Enumeration date
09/20/2005
Last updated
08/22/2007
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