Southeastern Family Practice Sc
Pediatric Adolescent Medicine
Southeastern Family Practice Sc is a Milwaukee, Wisconsin based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
1308 S 16th St, Milwaukee, Wisconsin - 53204-2711. They can be contacted on phone at
414-831-0100 and fax number 414-831-1584.
NPI number (Unique professional ID) for Southeastern Family Practice Sc is
1134303621 which was assigned by NPPES on 20 Dec, 2007 and it was last updated on 20 Dec, 2007.
Southeastern Family Practice Sc license number is
26529 for Pediatrics Adolescent Medicine (2080A0000X) in Wisconsin.
Southeastern Family Practice Sc specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Southeastern Family Practice Sc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Southeastern Family Practice Sc |
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Business Address:
Southeastern Family Practice Sc address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1308 S 16th St
Milwaukee, WI, 53204-2711
United States |
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| Phone Number : | 414-831-0100 |
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| Fax Number : | 414-831-1584 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1134303621 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 20 Dec, 2007 |
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| Last Updated On : | 20 Dec, 2007 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Noemia Prieto |
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| Authorized Official Credential : | MD |
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| Official Title or Position : | PRESIDENT |
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| Phone Number : | 414-463-6640 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Southeastern Family Practice Sc are as mentioned. Primary taxonomy code for Southeastern Family Practice Sc is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 207R00000X | Internal Medicine | No | 48505 | WI |
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 26529 | WI |
Legacy Identifiers:
Other legacy medical identifiers of Southeastern Family Practice Sc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 30718400 | MEDICAID | WI | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 8532 W Capitol Dr
Milwaukee, WI, 53222-1848
United States |
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| Phone Number : | 414-463-6640 |
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| Fax Number : | 414-463-6743 |
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Business Location:
Patients can refer following map for directions to
Southeastern Family Practice Sc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.