| River Glen Pediatrics | |
|
4655 N Port Washington Rd Ste 200 Glendale WI 53212-1076 | |
| (414) 247-9530 | |
| (414) 247-1875 |
| Full Name | River Glen Pediatrics |
|---|---|
| Speciality | Pediatrics |
| Location | 4655 N Port Washington Rd Ste 200, Glendale, Wisconsin |
| Authorized Official Name and Position | Smriti Khare (PRESIDENT, CHILDREN'S MEDICAL GROUP) |
| Authorized Official Contact | 4142667615 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| River Glen Pediatrics 9000 W Wisconsin Ave Ms 958 Milwaukee WI 53226-4874 Ph: (414) 266-7615 | River Glen Pediatrics 4655 N Port Washington Rd Ste 200 Glendale WI 53212-1076 Ph: (414) 247-9530 |
| NPI Number | 1710152954 |
|---|---|
| Provider Enumeration Date | 04/29/2008 |
| Last Update Date | 09/27/2021 |
| Certification Date | 09/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710152954 | NPI | - | NPPES |
| 1710152954 | Medicaid | WI |
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