Healthcare Provider Details
I. General information
NPI: 1649291543
Provider Name (Legal Business Name): JAMES L SCHULGIT MD FACC SC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2006
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2901 W KINNICKINNIC RIVER PKWY STE 103
MILWAUKEE WI
53215-3621
US
IV. Provider business mailing address
2901 W KINNICKINNIC RIVER PKWY STE 103
MILWAUKEE WI
53215-3621
US
V. Phone/Fax
- Phone: 414-649-3610
- Fax:
- Phone: 414-649-3610
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
L
SCHULGIT
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 414-649-3610