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General NPI Number Information
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NPI Number | 1922497908
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Entity Type | Organization
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Legal Business Name | BLUESTONE PHYSICIAN SERVICES WISCONSIN SC
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Dates
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Enumeration Date | 01/14/2015
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 342 N WATER ST STE 600
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City | MILWAUKEE
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State | WI
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Zip | 53202-5715
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Country | US
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Telephone | 651-342-1039
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Fax | 651-342-1428
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Provider Business Mailing Address
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Address Line | 342 N WATER ST STE 600
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City | MILWAUKEE
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State | WI
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Zip | 53202-5715
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Country | US
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Telephone | 651-342-1039
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Fax | 651-342-1428
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Authorized Official
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Title or Position | CEO
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Name | RAJIV N PATEL
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Credential | MD
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Telephone | 314-852-9479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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