Healthcare Provider Details

I. General information

NPI: 1417904756
Provider Name (Legal Business Name): METROPOLITAN MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4495 N OAKLAND AVE
SHOREWOOD WI
53211-1611
US

IV. Provider business mailing address

4495 N OAKLAND AVE
SHOREWOOD WI
53211-1611
US

V. Phone/Fax

Practice location:
  • Phone: 414-967-3550
  • Fax: 414-967-3551
Mailing address:
  • Phone: 414-967-3550
  • Fax: 414-967-3551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE ELERT
Title or Position: BILLING
Credential:
Phone: 414-967-3550