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NPI Code Detail

MEDICARE: FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS INC

MEDICARE: FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS INC
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1225476740
Entity Type Code : Organization
Provider Name (Legal Business Name) : FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS INC
Provider Business Mailing Address
First Line : N74W12501 LEATHERWOOD CT
Second Line :
City : MENOMONEE FALLS
State : WI
Zip : 53051-4490
Country : US
Telephone Number : 414-777-0417
Fax Number : 414-777-0096
Provider Business Practice Location Address
First Line : 1700 W PARADISE DR
Second Line :
City : WEST BEND
State : WI
Zip : 53095-9795
Country : US
Telephone Number : 262-334-3451
Fax Number : 262-334-5321
Authorized Official
Title or Position : PRESIDENT & CEO
Name : AMIR ABBAS GHAFERI
Credential : MD
Telephone Number : 734-660-4939
Provider Enumeration Date : 06/06/2013
Last Update Date : 03/02/2026

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Directions to “FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS INC ” Practice Location

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