| Southeastern Pediatrics, Sc | |
|
10625 W North Ave Ste 326 Wauwatosa WI 53226-2315 | |
| (414) 771-0500 | |
| (414) 771-0363 |
| Full Name | Southeastern Pediatrics, Sc |
|---|---|
| Speciality | Pediatrics |
| Location | 10625 W North Ave Ste 326, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Ratidzai Rioga (PRESIDENT) |
| Authorized Official Contact | 4147710500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeastern Pediatrics, Sc 7592 Solutions Ctr # 777592 Chicago IL 60677-7005 Ph: (262) 641-3700 | Southeastern Pediatrics, Sc 10625 W North Ave Ste 326 Wauwatosa WI 53226-2315 Ph: (414) 771-0500 |
| NPI Number | 1154765410 |
|---|---|
| Provider Enumeration Date | 04/17/2013 |
| Last Update Date | 06/02/2022 |
| Medicare PECOS PAC ID | 1850667114 |
|---|---|
| Medicare Enrollment ID | O20171101000917 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154765410 | NPI | - | NPPES |
| Provider Name | Ratidzai Rioga |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437215001 PECOS PAC ID: 8628205309 Enrollment ID: I20171101001067 |
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