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SOUTHEASTERN PEDIATRICS SC NPI 1154765410


NPI Information

NPI: 1154765410
Provider Name: SOUTHEASTERN PEDIATRICS, SC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
10625 W NORTH AVE STE 326
WAUWATOSA, WI
ZIP 53226
Phone: (414) 771-0500
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SOUTHEASTERN PEDIATRICS, SC is a pediatrics in Wauwatosa, WI. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SOUTHEASTERN PEDIATRICS, SC NPI is 1154765410. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10625 W NORTH AVE STE 326
WAUWATOSA, WI
ZIP 53226-315
Phone: (414) 771-0500
Fax: (414) 771-0363

The provider's authorized official is Ratidzai Rioga .
The authorized official title is President and has the following contact phone number (414) 771-0500.

The enumeration date for this NPI number is 4/17/2013 and was last updated on 6/2/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine41265WISCONSINNo
22080A0000XPediatricsAdolescent Medicine41265WISCONSINNo
3208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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