Northeast Obgyn Sc

NPI #1508936154 in Glendale, Wisconsin

Provider Information

NPI Number: 1508936154
Entity Type: Organization
Organization Name: Northeast Obgyn Sc
Primary Specialty: Obstetrics & Gynecology
Enumeration Date: Nov 9, 2006
Last Updated: Aug 13, 2021

Practice Location

Address: 7040 N PORT WASHINGTON RD
Address 2: SUITE 400
City: Glendale
State: Wisconsin
ZIP Code: 53217-3838
Phone: (414) 228-8888

Authorized Official

Name: DR. GARY P FAIT, MD
Title: PRESIDENT
Phone: (414) 228-8888

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X	Primary

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