Organization
GASTROENTEROLOGY MEDICINE S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LIDIA DIBA MBA (MANAGER)
(414) 671-0121
Entity
Organization
Contact information
Practice address
3201 S 16TH ST, 2015, MILWAUKEE, WI 53215-4537
(414) 671-0121
(414) 671-6949
Mailing address
3201 S 16TH ST, 2015, MILWAUKEE, WI 53215-4537
(414) 671-0121
(414) 671-6949
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
03/29/2006
Last updated
08/22/2020
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