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Organization

INFECTIOUS DISEASE SPECIALISTS, SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBRA MARIE THOMPSON M.D. (OWNER/PRESIDENT)
(414) 385-1213
Entity
Organization

Contact information

Practice address
2400 GOLF RD, PEWAUKEE, WI 53072-5590
(414) 385-1213
(414) 377-4821
Mailing address
3281 S SPRINGFIELD AVE, MILWAUKEE, WI 53207-3133
(414) 385-1213
(414) 377-4821

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
48852-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
48852-020
LICENSE
WI
Enumeration date
05/10/2011
Last updated
05/10/2011
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