MEDICARE: SEEN MEDICAL GROUP OF WI, CO.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1144054404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEEN MEDICAL GROUP OF WI, CO.

Provider Business Mailing Address
First Line	:	15 OAK ST STE 3
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02492-2470
Country	:	US
Telephone Number	:	339-793-8998
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 WILBURN RD STE 100
Second Line	:
City	:	SUN PRAIRIE
State	:	WI
Zip	:	53590-1478
Country	:	US
Telephone Number	:	339-793-8998
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BRITTA REIERSON
Credential	:	MD
Telephone Number	:	339-793-8998

Provider Enumeration Date	:	08/29/2024
Last Update Date	:	08/29/2024

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