Provider Demographics
NPI:1154527455
Name:RHEUMATOLOGY AND IMMUNOTHERAPY
Entity type:Organization
Organization Name:RHEUMATOLOGY AND IMMUNOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-435-0025
Mailing Address - Street 1:4225 W OAKWOOD PARK CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8131
Mailing Address - Country:US
Mailing Address - Phone:414-435-0025
Mailing Address - Fax:414-435-0026
Practice Address - Street 1:4225 W OAKWOOD PARK CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8131
Practice Address - Country:US
Practice Address - Phone:414-435-0025
Practice Address - Fax:414-435-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000001437Medicare PIN