| Ozaukee Medical Group, Llc | |
|
407 N Main St Thiensville WI 53092-1212 | |
| (262) 242-3000 | |
| (262) 242-7191 |
| Full Name | Ozaukee Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 407 N Main St, Thiensville, Wisconsin |
| Authorized Official Name and Position | Bruce C Herman (MANAGER) |
| Authorized Official Contact | 2622423000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ozaukee Medical Group, Llc 407 N Main St Thiensville WI 53092-1212 Ph: (262) 242-3000 | Ozaukee Medical Group, Llc 407 N Main St Thiensville WI 53092-1212 Ph: (262) 242-3000 |
| NPI Number | 1326125469 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 10/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326125469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 21717 (Wisconsin) | Primary |
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