| Brandon Overholt, | |
|
2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | |
| (414) 649-6000 | |
| Not Available |
| Full Name | Brandon Overholt |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Neurocritical Care |
| Location | 2900 W Oklahoma Ave, Milwaukee, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275064792 | NPI | - | NPPES |
| 100095429 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A2900X | Psychiatry & Neurology - Neurocritical Care | 72336 (Wisconsin) | Primary |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Mailing Address | Practice Location Address |
|---|---|
| Brandon Overholt, Po Box 735044, Chicago, IL 60673-3522 Ph: (414) 649-6000 | Brandon Overholt, 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 Ph: (414) 649-6000 |
Christopher R Takala, DO Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 9000 W Wisconsin Ave, Pediatric Psychiatry, Milwaukee, WI 53226 Phone: 414-607-5280 | |
Mr. Joseph S. Goveas, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1155 N Mayfair Rd, Department Of Psychiatry, Milwaukee, WI 53226 Phone: 414-955-8900 Fax: 414-955-6285 | |
Dr. Bhupendra O Khatri, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 3237 S 16th St, Milwaukee, WI 53215 Phone: 414-769-4040 Fax: 414-769-4041 | |
Joshua E Medow, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Neurocritical Care, Milwaukee, WI 53226 Phone: 414-805-8710 Fax: 414-805-1101 | |
Gina G Negrette, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 820 N Plankinton Ave, Milwaukee, WI 53203 Phone: 414-273-1991 | |
Dr. John Pankiewicz, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 821 W State St, Suite 504, Milwaukee, WI 53233 Phone: 414-278-4690 Fax: 414-223-1817 | |
Dr. Kelly Jean Wahlen, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 2025 E Newport Ave Bldg D7th, Milwaukee, WI 53211 Phone: 414-229-7429 |