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General NPI Number Information
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NPI Number | 1417969452
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Entity Type | Organization
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Legal Business Name | CARDIOGRAPHICS PHYSICIANS ST. MARY'S MILWAUKEE, LTD.
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2323 N LAKE DR
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City | MILWAUKEE
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State | WI
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Zip | 53211-4508
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Country | US
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Telephone | 414-291-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 11716 W GREENFIELD AVE
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City | WEST ALLIS
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State | WI
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Zip | 53214-2156
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Country | US
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Telephone | 414-778-3860
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Fax | 414-778-3886
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOAN GNADT
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Credential | M.D.
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Telephone | 414-291-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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