MEDICARE: SANDRA M ARCE-GARZON M.D.

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	208000000X	Pediatrics Physician	47372	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7281612	OTHER	WI	AETNA
2	7689455	OTHER	WI	CIGNA
3	2277365	OTHER	WI	CCN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1200986	OTHER	WI	COMPCARE/IPN
6	2276529	OTHER	WI	FIRST HEALTH CARE

General Provider Information

NPI Number	:	1669477394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA M ARCE-GARZON M.D.

Provider Business Mailing Address
First Line	:	4220 S 27TH ST. STE 200
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-1855
Country	:	US
Telephone Number	:	414-282-5810
Fax Number	:	414-282-5468

Provider Business Practice Location Address
First Line	:	4220 S 27TH ST STE 200
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-1855
Country	:	US
Telephone Number	:	414-282-5810
Fax Number	:	414-282-5468

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	03/07/2023

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Directions to “ SANDRA M ARCE-GARZON M.D.” Practice Location

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