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General NPI Number Information
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NPI Number | 1871634741
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Entity Type | Organization
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Legal Business Name | MORELAND FAMILY MEDICINE ASSOCIATES, S.C.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 717 MORELAND BLVD
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City | WAUKESHA
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State | WI
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Zip | 53188-2432
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Country | US
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Telephone | 262-542-9100
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Fax | 262-542-7366
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Provider Business Mailing Address
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Address Line | 717 MORELAND BLVD
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City | WAUKESHA
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State | WI
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Zip | 53188-2432
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Country | US
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Telephone | 262-542-9100
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Fax | 262-542-7366
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Authorized Official
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Title or Position | CLINIC ADMINISTRATOR
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Name | MR. JOHN HAYS
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Credential |
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Telephone | 262-970-8110
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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 |
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License Number State |
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