| Organization Name: | COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE, INC |
| NPI Number: | 1215945456 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TRAVIS ANDERSEN (PRESIDENT/CEO) |
| Mailing Address: | 9233 N Green Bay Rd Brown Deer |
| State: | WI US |
| Postal Code: | 532091103 |
| Phone Number: | 4142708150 |
| Fax Number: | |
| NPI Enumeration Date: | 08/03/2006 |
| NPI Last Update Date: | 04/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |