Provider Demographics
NPI:1992274260
Name:WISCONSIN MICHIGAN PHYSICIANS, SC
Entity type:Organization
Organization Name:WISCONSIN MICHIGAN PHYSICIANS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF/HR COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHINDERLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-724-6377
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:NIAGARA
Mailing Address - State:WI
Mailing Address - Zip Code:54151-0006
Mailing Address - Country:US
Mailing Address - Phone:888-724-6377
Mailing Address - Fax:715-251-1681
Practice Address - Street 1:10945 N PORT WASHINGTON RD STE 201
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-5078
Practice Address - Country:US
Practice Address - Phone:262-478-0301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WISCONSIN MICHIGAN PHYSICIANS, SC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies