Organization Name: | NORTHEAST OBGYN SC |
NPI Number: | 1508936154 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY P FAIT (PRESIDENT) |
Mailing Address: | 7040 N Port Washington Rd Suite 400 Glendale |
State: | WI US |
Postal Code: | 532173838 |
Phone Number: | 4142288888 |
Fax Number: | 4142288390 |
NPI Enumeration Date: | 11/09/2006 |
NPI Last Update Date: | 06/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |