CHARLES GRADE MD LLC NPI 1922267483

NPI Information

NPI: 1922267483
Provider Name: CHARLES GRADE MD, LLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
7845 HARWOOD AVE
WAUWATOSA, WI
ZIP 53213
Phone: (414) 270-1011
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CHARLES GRADE MD, LLC is an adult mental health clinic center in Wauwatosa, WI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. CHARLES GRADE MD, LLC NPI is 1922267483. The provider is registered as an organization entity type.

The provider's business location address is:

7845 HARWOOD AVE
WAUWATOSA, WI
ZIP 53213-523
Phone: (414) 270-1011
Fax: (414) 270-1031

The provider's authorized official is Charles M Grade .
The authorized official title is Psychiatrist and has the following contact phone number (414) 270-1011.

The enumeration date for this NPI number is 6/9/2008 and was last updated on 6/24/2021.

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
1	261QM0850X	Clinic/Center	Adult Mental Health	32662	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	31874500	MEDICAID	WISCONSIN

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: 4/28/2024

NPI Synchronization or Removal

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