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General NPI Number Information
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NPI Number | 1245387992
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Entity Type | Organization
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Legal Business Name | DIALYSIS ACCESS SOLUTIONS, LLC
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10000 W BLUEMOUND RD
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City | WAUWATOSA
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State | WI
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Zip | 53226-4321
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Country | US
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Telephone | 262-784-5390
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Fax |
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Provider Business Mailing Address
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Address Line | 890 ELM GROVE RD SUITE 211
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City | ELM GROVE
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State | WI
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Zip | 53122-2528
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Country | US
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Telephone | 262-784-5390
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Fax | 262-784-5472
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL I LEVINE
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Credential | MD
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Telephone | 414-778-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 38379
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License Number State | WI
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