Organization
CHILDREN'S MEDICAL GROUP
Active
Parent organization
CHILDREN'S MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S MEDICAL GROUP
Authorized official
DR. SMRITI KHARE M.D. (PRESIDENT, CHILDREN'S MEDICAL GROUP)
(414) 266-7615
Entity
Organization
Contact information
Practice address
3365 S 103RD ST STE 210, MILWAUKEE, WI 53227-4108
(262) 814-7080
(262) 432-9004
Mailing address
9000 W WISCONSIN AVE, MAIL STATION 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831502327
—
WI
Enumeration date
06/03/2014
Last updated
06/20/2022
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