Great Midwest Medical, Inc.
NPI #1629356423 in Brookfield, Wisconsin
Provider Information
- NPI Number
- 1629356423
- Entity Type
- Organization
- Organization Name
- Great Midwest Medical, Inc.
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Jul 27, 2011
- Last Updated
- Dec 7, 2011
Practice Location
- Address
- 17495 W CAPITOL DR
- Address 2
- UNIT K
- City
- Brookfield
- State
- Wisconsin
- ZIP Code
- 53045-2059
- Phone
- (262) 945-1094
Authorized Official
- Name
- DR. ROBERT DONALD MATTEUCCI, D.P.M.
- Title
- PRESIDENT
- Phone
- (262) 945-1094
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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