Organization
CHARLES GRADE MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES M GRADE M.D. (PSYCHIATRIST)
(414) 270-1011
Entity
Organization
Contact information
Practice address
7845 HARWOOD AVE, WAUWATOSA, WI 53213-2523
(414) 270-1011
(414) 270-1031
Mailing address
7845 HARWOOD AVE, WAUWATOSA, WI 53213-2523
(414) 270-1011
(414) 270-1031
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
32662
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31874500
—
WI
Enumeration date
06/09/2008
Last updated
06/24/2021
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