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FAMILY PRACTICE CLINIC OF MAYFAIR SC NPI 1295810208


NPI Information

NPI: 1295810208
Provider Name: FAMILY PRACTICE CLINIC OF MAYFAIR SC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
11803 W NORTH AVE
WAUWATOSA, WI
ZIP 53226
Phone: (414) 258-5522
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FAMILY PRACTICE CLINIC OF MAYFAIR SC is a general practice in Wauwatosa, WI. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee FAMILY PRACTICE CLINIC OF MAYFAIR SC NPI is 1295810208. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

11803 W NORTH AVE
WAUWATOSA, WI
ZIP 53226
Phone: (414) 258-5522
Fax: (414) 258-1337

The provider's authorized official is Marlene B Knie .
The authorized official title is Office Manager and has the following contact phone number (414) 258-5522.

The enumeration date for this NPI number is 10/26/2006 and was last updated on 10/29/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral PracticeYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
130074100MEDICAIDWISCONSIN
2000002135MEDICARE PINWISCONSIN

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.