Organization
WILLIAM B. POTOS M.D. COMMONWEALTH MEDICAL GROUP
Active
Other names
Commonwealth Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MUTSCHELKNAUS (CEO)
(414) 777-5100
Entity
Organization
Contact information
Practice address
2500 W LAYTON AVE, SUITE 290, MILWAUKEE, WI 53221-5420
(414) 281-9651
Mailing address
2500 W LAYTON AVE, SUITE 290, MILWAUKEE, WI 53221-5420
(414) 281-9651
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14134
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30862500
—
WI
Enumeration date
06/04/2007
Last updated
09/19/2007
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