Healthcare Provider Details

I. General information

NPI: 1609373547
Provider Name (Legal Business Name): CHRISTOPHER ROBERT MERTENS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2018
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 W WISCONSIN AVE STE B620
MILWAUKEE WI
53226-4874
US

IV. Provider business mailing address

9000 W WISCONSIN AVE STE B620
MILWAUKEE WI
53226-4874
US

V. Phone/Fax

Practice location:
  • Phone: 414-266-6730
  • Fax: 414-266-6742
Mailing address:
  • Phone: 414-266-6730
  • Fax: 414-266-6742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number83582-20
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number83582-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: