MEDICARE: DR. BRADY WILLIAM MEUDT DDS

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	122300000X	Dentist	6002151	WI

General Provider Information

NPI Number	:	1558290049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADY WILLIAM MEUDT DDS

Provider Business Mailing Address
First Line	:	2515 UNIVERSITY DR APT Y
Second Line	:
City	:	MARINETTE
State	:	WI
Zip	:	54143-2749
Country	:	US
Telephone Number	:	608-295-7788
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 MARINETTE AVE
Second Line	:
City	:	MARINETTE
State	:	WI
Zip	:	54143-3864
Country	:	US
Telephone Number	:	715-801-2945
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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