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General NPI Number Information
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NPI Number | 1447365614
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Entity Type | Organization
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Legal Business Name | NOEMI A PRIETO MD SC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 07/16/2009
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Provider Practice Location Address
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Address Line | 8532 W CAPITOL DR
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City | MILWAUKEE
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State | WI
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Zip | 53222-1827
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Country | US
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Telephone | 414-463-6640
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Fax | 414-463-6743
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Provider Business Mailing Address
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Address Line | 1126 S. 70TH ST N500
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City | MILWAUKEE
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State | WI
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Zip | 53214
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Country | US
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Telephone | 414-455-4780
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Fax | 414-475-2936
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Authorized Official
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Title or Position | PRESIDENT
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Name | NOEMI A PRIETO
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Credential | MD
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Telephone | 414-463-6640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 26529
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License Number State | WI
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