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NPI Code Detail

MEDICARE: MARGARET J SERGON

MEDICARE: MARGARET J SERGON
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1629579453
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET J SERGON
Provider Business Mailing Address
First Line : 3390 S 43RD ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53219-4800
Country : US
Telephone Number : 240-593-4935
Fax Number :
Provider Business Practice Location Address
First Line : 1849 N DR MARTIN LUTHER KING DR STE 101
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3639
Country : US
Telephone Number : 414-347-1774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2018
Last Update Date : 02/27/2018

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Directions to “ MARGARET J SERGON ” Practice Location

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