Organization
EDDY D CO MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDY CO MD (PRESIDENT)
(414) 645-0920
Entity
Organization
Contact information
Practice address
3267 S 16TH ST, STE 105, MILWAUKEE, WI 53215-4500
(414) 645-0920
Mailing address
3267 S 16TH ST, STE 105, MILWAUKEE, WI 53215-4500
(414) 645-0920
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
19814
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061917005
RAILROAD MEDICARE
WI
05
—
30914600
—
WI
Enumeration date
12/18/2009
Last updated
05/11/2010
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