=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952637522
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBERT J FRITZ MD LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2009
-----------------------------------------------------
Last Update Date | 11/02/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3535 W OKLAHOMA AVE
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53215-4171
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-384-1372
-----------------------------------------------------
Fax | 414-384-1093
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3535 W OKLAHOMA AVE
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53215-4171
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-384-1372
-----------------------------------------------------
Fax | 414-384-1093
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ROBERT J FRITZ MD LTD
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 414-384-1372
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 13054
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------