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General NPI Number Information
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NPI Number | 1215167523
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Entity Type | Organization
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Legal Business Name | MARVIN
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Dates
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Enumeration Date | 07/21/2009
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Last Update Date | 07/21/2009
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Provider Practice Location Address
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Address Line | 1218 W KILBOURN AVE SUITE-401
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City | MILWAUKEE
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State | WI
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Zip | 53233-1330
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Country | US
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Telephone | 414-272-4629
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Fax | 414-272-4630
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Provider Business Mailing Address
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Address Line | 1218 W KILBOURN AVE SUITE-401
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City | MILWAUKEE
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State | WI
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Zip | 53233-1330
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Country | US
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Telephone | 414-272-4629
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Fax | 414-272-4630
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Authorized Official
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Title or Position | GENERAL SURGEON
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Name | DR. MARVIN EDWARD SATTLER
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Credential | M.D
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Telephone | 414-272-4629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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