Organization
WISCONSIN VASCULAR ACCESS AND NEPHROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LEVINE MD (OWNER)
(414) 427-7820
Entity
Organization
Contact information
Practice address
1962 N PROSPECT AVE # 310, MILWAUKEE, WI 53202-1414
(414) 803-2721
Mailing address
PO BOX 932, HALES CORNERS, WI 53130-0932
(414) 427-7820
(414) 427-7824
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
38379-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32303500
—
WI
Enumeration date
06/05/2009
Last updated
08/18/2009
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