Medina, Jeanne M
Medina, Jeanne M is an individual health care provider with primary practice located at 3289 N Mayfair Rd , Wauwatosa WI 53222-3203. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Medina, Jeanne M can be contacted via phone (414) 771-7900.Contact Information
Primary practice address
3289 N Mayfair Rd
Wauwatosa WI 53222-3203
Phone: (414) 771-7900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 23154 | Wisconsin |
Profile Details
| NPI number | 1942241914 |
|---|---|
| LBN Legal business name | Medina, Jeanne M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2006 |
| Last updated | Dec 16th, 2014 - about 10 years 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 | 1942241914 | NPPES |
| Wisconsin | MEDICAID | 30375500 |
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