Healthcare Provider Details

I. General information

NPI: 1457329534
Provider Name (Legal Business Name): NICHOLAS N ARMSTRONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 S. LAKE DRIVE
CUDAHY WI
53110-3171
US

IV. Provider business mailing address

100 15TH AVE #180
SOUTH MILWAUKEE WI
53172-1160
US

V. Phone/Fax

Practice location:
  • Phone: 414-489-4190
  • Fax: 414-489-4015
Mailing address:
  • Phone: 414-768-5430
  • Fax: 414-762-4225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35530-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: