MEDICARE: OAKWOOD FAMILY MEDICAL CLINIC,S.C.

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
1	261QP2300X	Primary Care Clinic/Center	36860	WI

Other Identifiers

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

General Provider Information

NPI Number	:	1235388604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKWOOD FAMILY MEDICAL CLINIC,S.C.

Provider Business Mailing Address
First Line	:	1845 N FARWELL AVE STE 207
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-1715
Country	:	US
Telephone Number	:	414-270-0777
Fax Number	:

Provider Business Practice Location Address
First Line	:	1845 N FARWELL AVE STE 207
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-1715
Country	:	US
Telephone Number	:	414-270-0777
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CRAIG ALAN REICH
Credential	:	M.D.
Telephone Number	:	414-270-0777

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	11/21/2008

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Directions to “OAKWOOD FAMILY MEDICAL CLINIC,S.C. ” Practice Location

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