Organization
FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS
Active
Parent organization
FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS
Organization subpart
Yes
Provider details
NPI number
Legal business name
FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS
Authorized official
RANDALL NEWMAN (VP OF FINANCE)
(414) 777-7963
Entity
Organization
Contact information
Practice address
11040 N RANGE LINE RD, MEQUON, WI 53092-4930
(262) 253-5230
Mailing address
11040 N RANGE LINE RD, MEQUON, WI 53092-4930
(262) 253-5230
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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