Organization
CLINIC OF COSMETIC SURGERY SC
Active
Other names
Roger C Mixter MD SC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTINE K SCHNEIDER (BUSINESS MANAGER)
(414) 963-0500
Entity
Organization
Contact information
Practice address
5201 N PORT WASHINGTON RD, MILWAUKEE, WI 53217-4902
(414) 963-0500
(414) 963-0359
Mailing address
5201 N PORT WASHINGTON RD, MILWAUKEE, WI 53217-4902
(414) 963-0500
(414) 963-0359
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30618600
—
WI
Enumeration date
09/20/2007
Last updated
01/23/2018
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