Family Practice Clinic of Mayfair SC
Family Practice Clinic of Mayfair SC is a General Practice Physician in Wauwatosa, Wisconsin. Registered with an NPI since 2006.
- In the registry since
- 2006
Practice location Address checks out
11803 W North AveWauwatosa, WI 53226
Phone: (414) 258-5522
Fax: (414) 258-1337
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Physician (primary) | Taxonomy 208D00000X |
|---|
Record details
| NPI number | 1295810208 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Marlene Knie — Office Manager · (414) 258-5522 |
| NPI enumerated | October 26, 2006 |
| Last updated in NPPES | October 29, 2007 |
| Mailing address | 11803 W North Ave, Wauwatosa, WI 53226 |
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Dr. Annaliese Marie Koller Shumate, DO
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