Organization Name: | BADGER CARE LLC |
NPI Number: | 1578850699 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SALAM U SYED (PRESIDENT/OWNER) |
Mailing Address: | 1300 S Green Bay Rd #205 Mount Pleasant |
State: | WI US |
Postal Code: | 534064469 |
Phone Number: | 3472769281 |
Fax Number: | 4142479004 |
NPI Enumeration Date: | 07/10/2011 |
NPI Last Update Date: | 07/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 53833 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |