Organization
OPEN ADVANCED MRI OF MILWAUKEE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN BROGHAMMER MD (MD)
(262) 782-1800
Entity
Organization
Contact information
Practice address
12780 W NORTH AVE, B, BROOKFIELD, WI 53005-4628
(262) 782-1800
(262) 782-8118
Mailing address
12780 W NORTH AVE, B, BROOKFIELD, WI 53005-4628
(262) 782-1800
(262) 782-8118
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32873200
—
WI
Enumeration date
01/17/2006
Last updated
08/22/2020
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