| Lutfi T Tombuloglu MD SC | |
|
4325 S 60th St Greenfield WI 53220-3508 | |
| (414) 545-5500 | |
| (414) 545-5335 |
| Full Name | Lutfi T Tombuloglu MD SC |
|---|---|
| Speciality | Clinic/Center |
| Location | 4325 S 60th St, Greenfield, Wisconsin |
| Authorized Official Name and Position | Bedriye Tombuloglu (PRESIDENT) |
| Authorized Official Contact | 4145455500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutfi T Tombuloglu MD SC 4325 S 60th St Greenfield WI 53220-3508 Ph: (414) 545-5500 | Lutfi T Tombuloglu MD SC 4325 S 60th St Greenfield WI 53220-3508 Ph: (414) 545-5500 |
| NPI Number | 1881743821 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 11/09/2022 |
| Certification Date | 11/09/2022 |
| Medicare PECOS PAC ID | 0941390041 |
|---|---|
| Medicare Enrollment ID | O20071213000054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881743821 | NPI | - | NPPES |
| 30966100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 17161-020 (Wisconsin) | Primary |
| Provider Name | Bedriye MD Tombuloglu |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1811083009 PECOS PAC ID: 0143494401 Enrollment ID: I20111122000837 |
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