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General NPI Number Information
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NPI Number | 1598850299
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Entity Type | Organization
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Legal Business Name | OBSTETRICS & GYNECOLOGY, S.C.
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 12/15/2008
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Provider Practice Location Address
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Address Line | 3040 N 117TH ST SUITE 200
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City | WAUWATOSA
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State | WI
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Zip | 53222-4128
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Country | US
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Telephone | 414-778-0070
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Fax | 414-778-0359
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Provider Business Mailing Address
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Address Line | 3040 N 117TH ST SUITE 200
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City | WAUWATOSA
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State | WI
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Zip | 53222-4128
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Country | US
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Telephone | 414-778-0070
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Fax | 414-778-0359
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Authorized Official
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Title or Position | SUPERVISOR
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Name | MRS. SUSAN DORSEY
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Credential | CPC
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Telephone | 414-778-0070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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