| Family Doctors, Sc | |
|
3267 S 16th St Suite 208 Milwaukee WI 53215-4500 | |
| (414) 643-7448 | |
| (414) 643-7482 |
| Full Name | Family Doctors, Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 3267 S 16th St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Suresh K Misra (OWNER) |
| Authorized Official Contact | 4146437448 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Doctors, Sc 3267 S 16th St Suite 208 Milwaukee WI 53215-4500 Ph: (414) 643-7448 | Family Doctors, Sc 3267 S 16th St Suite 208 Milwaukee WI 53215-4500 Ph: (414) 643-7448 |
| NPI Number | 1043242811 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 10/24/2007 |
| Medicare PECOS PAC ID | 0345230983 |
|---|---|
| Medicare Enrollment ID | O20040514000963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043242811 | NPI | - | NPPES |
| 21251200 | Medicaid | WI | |
| CH8008 | Other | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 21429 (Wisconsin) | Primary |
| Provider Name | Suresh K Misra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174588768 PECOS PAC ID: 2961492509 Enrollment ID: I20040519000598 |
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