| Columbia St. Mary's Hospital Milwaukee, Inc | |
|
13111 N Port Washington Rd Mequon WI 53097-2416 | |
| (414) 270-4932 | |
| Not Available |
| Full Name | Columbia St. Mary's Hospital Milwaukee, Inc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 13111 N Port Washington Rd, Mequon, Wisconsin |
| Authorized Official Name and Position | Michael Mccullough (CFO) |
| Authorized Official Contact | 4144653736 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia St. Mary's Hospital Milwaukee, Inc 4425 N Port Washington Rd Glendale WI 53212-1082 Ph: (414) 326-2100 | Columbia St. Mary's Hospital Milwaukee, Inc 13111 N Port Washington Rd Mequon WI 53097-2416 Ph: (414) 270-4932 |
| NPI Number | 1710928221 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 03/24/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710928221 | NPI | - | NPPES |
| 100008370 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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