| Mcmc Urgicare Llc | |
|
5310 W Capitol Dr 101 Milwaukee WI 53216-2263 | |
| (414) 431-5004 | |
| (414) 431-2959 |
| Full Name | Mcmc Urgicare Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5310 W Capitol Dr, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Syed Gouse Mohiuddin (DEDICAL DIRECTOR) |
| Authorized Official Contact | 4144315004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcmc Urgicare Llc 5310 W Capitol Dr 101 Milwaukee WI 53216-2263 Ph: (414) 431-5004 | Mcmc Urgicare Llc 5310 W Capitol Dr 101 Milwaukee WI 53216-2263 Ph: (414) 431-5004 |
| NPI Number | 1134238017 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0648220244 |
|---|---|
| Medicare Enrollment ID | O20050131000681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134238017 | NPI | - | NPPES |
| 21270100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Syed G Mohiuddin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427013499 PECOS PAC ID: 4385548593 Enrollment ID: I20031120000355 |
| Provider Name | Fuad S Ahmad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871602896 PECOS PAC ID: 9335147669 Enrollment ID: I20061121000568 |
| Provider Name | Dalia F Shahwan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598018459 PECOS PAC ID: 7911142724 Enrollment ID: I20130327000514 |
| Provider Name | Byung Geun Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114326758 PECOS PAC ID: 6507188190 Enrollment ID: I20141210001333 |
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