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General NPI Number Information
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NPI Number | 1750561874
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Entity Type | Organization
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Legal Business Name | WISCONSIN HEART AND VASCULAR CLINICS SC
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 601 N 99TH ST SUITE #201
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City | WAUWATOSA
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State | WI
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Zip | 53226-4339
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Country | US
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Telephone | 414-778-7790
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Fax | 414-476-8253
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Provider Business Mailing Address
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Address Line | 601 N 99TH ST SUITE #201
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City | WAUWATOSA
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State | WI
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Zip | 53226-4339
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Country | US
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Telephone | 414-778-7790
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Fax | 414-476-8253
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID K ASHPOLE
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Credential | M.D.
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Telephone | 414-778-7790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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