Mayville Family Practice LLC

NPI #1154821387 in West Bend, Wisconsin

Provider Information

NPI Number: 1154821387
Entity Type: Organization
Organization Name: Mayville Family Practice LLC
Primary Specialty: Family Medicine
Enumeration Date: Feb 14, 2018
Last Updated: Aug 25, 2021

Practice Location

Address: 5595 COUNTY ROAD Z
City: West Bend
State: Wisconsin
ZIP Code: 53095-9224
Phone: (262) 339-3038

Authorized Official

Name: DR. CHARLES EDWARD SAMMIS, DO
Title: PHYSICIAN/OWNER
Phone: (262) 339-3033

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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