| Mark B. Smuckler Md Ltd | |
|
155 E Silver Spring Dr 203 Milwaukee WI 53217-4704 | |
| (414) 332-2450 | |
| (414) 332-1390 |
| Full Name | Mark B. Smuckler Md Ltd |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 155 E Silver Spring Dr, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Mark B Smuckler (PRESIDENT) |
| Authorized Official Contact | 4143322450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark B. Smuckler Md Ltd 155 E Silver Spring Dr 203 Milwaukee WI 53217-4704 Ph: (414) 332-2450 | Mark B. Smuckler Md Ltd 155 E Silver Spring Dr 203 Milwaukee WI 53217-4704 Ph: (414) 332-2450 |
| NPI Number | 1528344819 |
|---|---|
| Provider Enumeration Date | 10/31/2011 |
| Last Update Date | 10/31/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528344819 | NPI | - | NPPES |
| 30954800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 16139 (Wisconsin) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 16139 (Wisconsin) | Secondary |
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