Healthcare Provider Details

I. General information

NPI: 1669622247
Provider Name (Legal Business Name): CITY OF MILWAUKEE HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 09/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 N BROADWAY FL 3
MILWAUKEE WI
53202-3639
US

IV. Provider business mailing address

841 N BROADWAY FL 3
MILWAUKEE WI
53202-3639
US

V. Phone/Fax

Practice location:
  • Phone: 414-286-3521
  • Fax:
Mailing address:
  • Phone: 414-286-3521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BEVAN K BAKER
Title or Position: COMMISSIONER OF HEALTH
Credential: FACHE
Phone: 414-286-3521