| Jeid SC | |
|
2900 W Oklahoma Ave Milwaukee WI 53215-4330 | |
| (414) 649-6000 | |
| (414) 649-1325 |
| Full Name | Jeid SC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2900 W Oklahoma Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Jairo a Eraso Zamaro (OWNER) |
| Authorized Official Contact | 4143643037 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeid SC Po Box 71807 Richmond VA 23255-1807 Ph: (804) 350-2889 | Jeid SC 2900 W Oklahoma Ave Milwaukee WI 53215-4330 Ph: (414) 649-6000 |
| NPI Number | 1457625709 |
|---|---|
| Provider Enumeration Date | 03/05/2012 |
| Last Update Date | 02/22/2023 |
| Certification Date | 02/22/2023 |
| Medicare PECOS PAC ID | 1951565639 |
|---|---|
| Medicare Enrollment ID | O20120608000182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457625709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 50877-20 (Wisconsin) | Primary |
| Provider Name | Jairo a Eraso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760664940 PECOS PAC ID: 5597838631 Enrollment ID: I20080722000608 |
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