Martin Men's Medical Clinic of Wisconsin

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

20798-020 Issued in WI

Legal business name

MARTIN MEN'S MEDICAL CLINIC OF WISCONSIN

Practice address

2949 N Mayfair Rd Ste 300
Wauwatosa, WI 53222-4304

Phone

(414) 454-6000

Fax

(414) 454-6420

NPI assigned

Sep 22, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Moeller

Title

Clinic Director

Phone

(414) 454-6000

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253577600000",
    "number": "1184958209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2949 N MAYFAIR RD STE 300",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224304",
            "telephone_number": "414-454-6000",
            "fax_number": "414-454-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2949 N MAYFAIR RD STE 300",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224304",
            "telephone_number": "414-454-6000",
            "fax_number": "414-454-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN MEN'S MEDICAL CLINIC OF WISCONSIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-22",
        "last_updated": "2009-09-22",
        "status": "A",
        "authorized_official_last_name": "MOELLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "414-454-6000"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "20798-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zarina Markova, MD
• Sarah Marowski-Richmond, MD
• Keely Marshall, M.D.
• Tim Daniel Marsho, DO
• Cindy L Marti, P.T.
• Bethany Liann Martin
• Jennifer Catherine Martin, MT-BC
• John Martin, M.D.
• Lindsay Maruszewski
• Rebekah Marvel, LPC

• Clinic/Center in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.