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NPI Code Detail

MEDICARE: DIGESTIVE DISEASE SPECIALISTS OF WI

MEDICARE: DIGESTIVE DISEASE SPECIALISTS OF WI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114902293
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIGESTIVE DISEASE SPECIALISTS OF WI
Provider Business Mailing Address
First Line : W231N1440 CORPORATE CT
Second Line : SUITE 307
City : WAUKESHA
State : WI
Zip : 53186-1303
Country : US
Telephone Number : 262-896-6400
Fax Number : 262-896-8986
Provider Business Practice Location Address
First Line : W231N1440 CORPORATE CT
Second Line : SUITE 307
City : WAUKESHA
State : WI
Zip : 53186-1303
Country : US
Telephone Number : 262-896-6400
Fax Number : 262-896-8986
Authorized Official
Title or Position : OFFICE MANGER
Name : MS. JO ANNE SADOWSKI
Credential :
Telephone Number : 262-896-6400
Provider Enumeration Date : 12/12/2005
Last Update Date : 08/22/2020

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