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Organization

CHILDREN'S MEDICAL GROUP

Active
Parent organization
CHILDREN'S MEDICAL GROUP
Other names
Pavilion Pediatrics
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHILDREN'S MEDICAL GROUP
Authorized official
DR. THOMAS DUNIGAN MD (PRESIDENT, CHILDREN'S MEDICAL GROUP)
(414) 266-7615
Entity
Organization

Contact information

Practice address
2025 W OKLAHOMA AVE, SUITE 105, MILWAUKEE, WI 53215-4455
(414) 385-9638
(414) 385-9412
Mailing address
9000 W WISCONSIN AVE, MS 8000, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-3803

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32873900
WI
Enumeration date
04/29/2008
Last updated
06/17/2008
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