Pediatrics MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

43581020 Issued in WI

Legal business name

PEDIATRICS MD

Practice address

890 Elm Grove Rd
Elm Grove, WI 53122-2528

Phone

(414) 761-7000

NPI assigned

Feb 14, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ruchir Agrawal

Title

Owner

Phone

(414) 761-7000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326181082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5434 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 ELM GROVE RD",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222528",
            "telephone_number": "414-761-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AGRAWAL",
        "authorized_official_first_name": "RUCHIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-761-7000"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "43581020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Elm Grove, WI
• Providers in Elm Grove, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.