Kelly, Teresa Gross
Kelly, Teresa Gross is an individual health care provider with primary practice located at 9000 W Wisconsin Ave Pediatric Radiology, Milwaukee WI 53226-4874. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Radiology, which is considered as her primary health care specialty. Kelly, Teresa Gross can be contacted via phone (414) 266-1686.Contact Information
Primary practice address
9000 W Wisconsin Ave Pediatric Radiology
Milwaukee WI 53226-4874
Phone: (414) 266-1686
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | ME70684 | Florida |
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | 52993 | Wisconsin |
Profile Details
| NPI number | 1275580672 |
|---|---|
| LBN Legal business name | Kelly, Teresa Gross |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 30th, 2006 |
| Last updated | Mar 12th, 2024 - about 8 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275580672 | NPPES |
| Wisconsin | MEDICAID | 1275580672 | |
| Wisconsin | MEDICAID | 250150300 |
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