Cmh Primary Care Clinic Moutain-Physician Dispensary in Mountain - Family Medicine
Cmh Primary Care Clinic Moutain-Physician Dispensary - NPI 1962533455
Cmh Primary Care Clinic Moutain-Physician Dispensary is a Family Medicine in Mountain, Wisconsin. Cmh Primary Care Clinic Moutain-Physician Dispensary practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Cmh Primary Care Clinic Moutain-Physician Dispensary is 1962533455. The last update date is 2021-12-23.
Cmh Primary Care Clinic Moutain-Physician Dispensary's current location address is 14353 Hwy 32 & 64, Mountain, Wisconsin. You can contact this provider via phone number 7152761600 and fax number 7152761800. The mailing address for Cmh Primary Care Clinic Moutain-Physician Dispensary is 14353 Hwy 32 & 64, Mountain, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Cmh Primary Care Clinic Moutain-Physician Dispensary |
|---|---|
| Address | 14353 Hwy 32 & 64, Mountain, Wisconsin |
| Phone Number | 7152761600 |
| Fax Number | 7152761800 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PHYSICIAN |
|---|---|
| Authorized Official Name | Gremban C Douglas |
| Credentials | M.D. |
| Telephone Number | 7152761600 |
NPI Number Detail
| NPI Number | 1962533455 |
|---|---|
| Provider Enumeration Date | 2007-03-08 |
| Last Updated Date | 2021-12-23 |
Provider Mailing Address Detail
| Address | 14353 Hwy 32 & 64 |
|---|---|
| City | Mountain |
| State | Wisconsin (WI) |
| Post Code | 54149 |
| Phone Number | 7152761600 |
| Fax Number | 7152761800 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 23967-020 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5128904 | WI | NCPDP | |
| 395585708005 | WI | GREMBAN BC | |
| 31756500 | WI | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Cmh Primary Care Clinic Moutain-Physician Dispensary by the Centers for Medicare & Medicaid Services?
The Cmh Primary Care Clinic Moutain-Physician Dispensary has been issued the NPI (National Provider Identifier) 1962533455, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Cmh Primary Care Clinic Moutain-Physician Dispensary is located?
The Cmh Primary Care Clinic Moutain-Physician Dispensary is situated at the following address: 14353 Hwy 32 & 64, Mountain, WI, 54149.
What is Cmh Primary Care Clinic Moutain-Physician Dispensary's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Cmh Primary Care Clinic Moutain-Physician Dispensary's specialized field of practice is Family Medicine, and the corresponding taxonomy code that categorizes this area of specialization is 207Q00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1962533455 to Cmh Primary Care Clinic Moutain-Physician Dispensary?
The Cmh Primary Care Clinic Moutain-Physician Dispensary received its 1962533455 assignment from the Centers for Medicare & Medicaid Services on 2007-03-08.
As of what date were the details related to Cmh Primary Care Clinic Moutain-Physician Dispensary most recently updated or revised?
The information pertaining to Cmh Primary Care Clinic Moutain-Physician Dispensary, including its address, specialty, and other relevant details, was last updated or revised on 2021-12-23.