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General NPI Number Information
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NPI Number | 1861531378
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Entity Type | Organization
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Legal Business Name | GE BUTTERFIELD MDSC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 7007 N RANGE LINE RD
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City | GLENDALE
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State | WI
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Zip | 53209-2620
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Country | US
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Telephone | 414-352-3341
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Fax |
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Provider Business Mailing Address
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Address Line | 4555 W SCHROEDER DR SUITE 170
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City | MILWAUKEE
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State | WI
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Zip | 53223-1475
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Country | US
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Telephone | 414-365-3210
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Fax | 414-365-3225
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Authorized Official
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Title or Position | PRESIDENT
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Name | GAIL E BUTTERFIELD
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Credential | MD
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Telephone | 262-783-6634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 31429
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License Number State | WI
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