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NPI Code Detail

MEDICARE: DERMATOLOGY SERVICES, SC

MEDICARE: DERMATOLOGY SERVICES, SC
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
1207N00000XDermatology Physician18537WI
2207N00000XDermatology Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CS0892OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295783496
Entity Type Code : Organization
Provider Name (Legal Business Name) : DERMATOLOGY SERVICES, SC
Provider Business Mailing Address
First Line : 3077 N MAYFAIR RD
Second Line : SUITE 305
City : WAUWATOSA
State : WI
Zip : 53222-4305
Country : US
Telephone Number : 414-258-3500
Fax Number : 414-258-3501
Provider Business Practice Location Address
First Line : 3077 N MAYFAIR RD
Second Line : SUITE 305
City : WAUWATOSA
State : WI
Zip : 53222-4305
Country : US
Telephone Number : 414-258-3500
Fax Number : 414-258-3501
Authorized Official
Title or Position : OWNER
Name : SIDNEY HERSZENSON
Credential : MD
Telephone Number : 414-258-3500
Provider Enumeration Date : 05/04/2006
Last Update Date : 06/04/2012

Similar Medicare Providers

1174505333 — NICHOLAS ROBERT JULGA PA-C
Practice Location Address:
3077 N MAYFAIR RD STE 305
WAUWATOSA, WI
53222-4305
Practice Phone: 414-384-6700
Practice Fax: 414-727-1058
1285602482 — BINDU S. BAMRAH M.D.
Practice Location Address:
3077 N MAYFAIR RD STE 305
WAUWATOSA, WI
53222-4305
Practice Phone: 414-384-6700
Practice Fax:
1689643579 — JANET L. JASNIEWSKI N.P.
Practice Location Address:
3077 N MAYFAIR RD STE 305
WAUWATOSA, WI
53222-4305
Practice Phone: 414-384-6700
Practice Fax: 414-727-1058
1275502031 — BRIAN A. MCCARTY M.D.
Practice Location Address:
3077 N MAYFAIR RD STE 100
WAUWATOSA, WI
53222-4305
Practice Phone: 414-384-6700
Practice Fax: 414-727-1058
1750350914 — STEVEN M. ZABEL P.A.
Practice Location Address:
3077 N MAYFAIR RD STE 305
WAUWATOSA, WI
53222-4305
Practice Phone: 414-384-6700
Practice Fax: 414-727-1058
1295769321 — ORTHOPEDIC SURGEONS OF WISCONSIN, S.C.
Practice Location Address:
3077 N MAYFAIR RD STE 305
WAUWATOSA, WI
53222-4305
Practice Phone: 414-384-6700
Practice Fax: 414-727-1058

Directions to “DERMATOLOGY SERVICES, SC ” Practice Location

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