| Infectious Disease Specialists, Sc | |
|
2400 Golf Rd Pewaukee WI 53072-5590 | |
| (414) 385-1213 | |
| (414) 377-4821 |
| Full Name | Infectious Disease Specialists, Sc |
|---|---|
| Speciality | Clinic/center |
| Location | 2400 Golf Rd, Pewaukee, Wisconsin |
| Authorized Official Name and Position | Debra Marie Thompson (OWNER/PRESIDENT) |
| Authorized Official Contact | 4143851213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Disease Specialists, Sc 3281 S Springfield Ave Milwaukee WI 53207-3133 Ph: (414) 385-1213 | Infectious Disease Specialists, Sc 2400 Golf Rd Pewaukee WI 53072-5590 Ph: (414) 385-1213 |
| NPI Number | 1740572619 |
|---|---|
| Provider Enumeration Date | 05/10/2011 |
| Last Update Date | 05/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740572619 | NPI | - | NPPES |
| 48852-020 | Other | WI | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 48852-020 (Wisconsin) | Primary |
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