Sports Medicine Center S C

NPI #1093729055 in Appleton, Wisconsin

Provider Information

NPI Number: 1093729055
Entity Type: Organization
Organization Name: Sports Medicine Center S C
Primary Specialty: Orthopaedic Surgery
Enumeration Date: Jul 27, 2006
Last Updated: Jan 20, 2009

Practice Location

Address: 277 ALTENHOFEN DR
City: Appleton
State: Wisconsin
ZIP Code: 54913-8401
Phone: (920) 993-1643

Authorized Official

Name: DR. ETIENNE A MEJIA, M.D.
Title: PRESDIENT
Phone: (920) 993-1643

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X	Primary

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