Organization
ENT SPECIALISTS OF MILWAUKEE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY A MIX M.B.S. (BILLING MANAGER)
(414) 434-0266
Entity
Organization
Contact information
Practice address
8532 W CAPITOL DR, L1OO, MILWAUKEE, WI 53222-1827
(414) 434-0266
(414) 536-7001
Mailing address
8532 W CAPITOL DR, L1OO, MILWAUKEE, WI 53222-1827
(414) 434-0266
(414) 536-7001
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21287800
—
WI
Enumeration date
11/03/2006
Last updated
10/11/2011
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