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NPI Code Detail

MEDICARE: DR. GREGORY S NAZE M.D.

MEDICARE: DR. GREGORY S NAZE 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
1207L00000XAnesthesiology Physician24586-020WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2050061633OTHERRAIL ROAD 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 : 1982688347
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY S NAZE M.D.
Provider Business Mailing Address
First Line : 225 S EXECUTIVE DR
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-4266
Country : US
Telephone Number : 262-787-4026
Fax Number :
Provider Business Practice Location Address
First Line : 410 DEWEY ST
Second Line :
City : WISCONSIN RAPIDS
State : WI
Zip : 54494-4715
Country : US
Telephone Number : 715-423-8080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 02/15/2009

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