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General NPI Number Information
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NPI Number | 1750594297
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Entity Type | Organization
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Legal Business Name | ASCENSION SE WISCONSIN HOSPITAL, INC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 3070 N 51ST ST SUITE 601
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City | MILWAUKEE
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State | WI
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Zip | 53210-1645
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Country | US
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Telephone | 414-445-6520
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Fax |
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Provider Business Mailing Address
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Address Line | 3070 N 51ST ST SUITE 601
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City | MILWAUKEE
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State | WI
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Zip | 53210-1645
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Country | US
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Telephone | 414-445-6520
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MICHAEL MCCULLOUGH
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Credential |
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Telephone | 414-465-3736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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