| Commonwealth Medical Group, Llc | |
|
851 S 70th St Suite 101 West Allis WI 53214-3147 | |
| (414) 777-5100 | |
| (414) 777-5112 |
| Full Name | Commonwealth Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 851 S 70th St, West Allis, Wisconsin |
| Authorized Official Name and Position | John A. Mutschelknaus (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4147775100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Medical Group, Llc 851 S 70th St Suite 101 West Allis WI 53214-3147 Ph: (414) 777-5100 | Commonwealth Medical Group, Llc 851 S 70th St Suite 101 West Allis WI 53214-3147 Ph: (414) 777-5100 |
| NPI Number | 1477500361 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 10/09/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477500361 | NPI | - | NPPES |
| 21251000 | Medicaid | WI |
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