Provider Demographics
NPI:1316908874
Name:BATTISTA, JOSEPH C (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:BATTISTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3070 N 51ST ST
Mailing Address - Street 2:#207
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1645
Mailing Address - Country:US
Mailing Address - Phone:414-871-9500
Mailing Address - Fax:
Practice Address - Street 1:3070 N 51ST ST
Practice Address - Street 2:#207
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-1645
Practice Address - Country:US
Practice Address - Phone:414-871-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI25897208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
010021961OtherRR MEDICARE
WI31401200Medicaid
WI000102755Medicare PIN
WI000086032Medicare PIN
WI001001666Medicare PIN
B51412Medicare UPIN