Wisconsin Phlebology Medical Group Sc

NPI #1295780492 in Mequon, Wisconsin

Provider Information

NPI Number: 1295780492
Entity Type: Organization
Organization Name: Wisconsin Phlebology Medical Group Sc
Primary Specialty: Surgery
Enumeration Date: May 24, 2006
Last Updated: May 4, 2023

Practice Location

Address: 10614 N PORT WASHINGTON RD
City: Mequon
State: Wisconsin
ZIP Code: 53092-5013
Phone: (262) 834-0123

Authorized Official

Name: NATHAN AMORUSO
Title: SR VP REVENUE
Phone: (847) 593-8460

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery - Vascular Surgery — Vascular Surgery	2086S0129X
Phlebology	202K00000X
Radiology - Vascular & Interventional Radiology — Vascular & Interventional Radiology	2085R0204X
Surgery	208600000X	Primary

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