Allegiance Medical, Inc.

Organization Active NPI Internal Medicine Physician · Oconomowoc, WI

NPI 1831862895 · NPPES record last updated Jun 27, 2023

Key facts

NPI
1831862895
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
ALLEGIANCE MEDICAL, INC.
Practice address
888 Thackeray TRL Ste 103
Oconomowoc, WI 53066-4342
Phone
(844) 726-3926
Fax
(844) 726-3926
NPI assigned
Jul 27, 2021
Organization subpart
No

Authorized official

Name
Eric M Elliot, DMSC, PA-C
Title
President
Phone
(844) 726-3926

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2328858Allegiance Medical, SC
888 Thackeray Trail, Suite 103, Oconomowoc, WI 53066
Certificate of waiverAug 18, 2027

National Provider Directory

Locations

925 Genesee St
Unit 180620
Delafield, WI 53018

200 W Summit Ave
Ste 290
Wales, WI 53183
Phone (844) 726-3926

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X Yes

Addresses

Primary practice location

888 Thackeray TRL Ste 103
Oconomowoc, WI 53066-4342

Mailing address

925 Genesee St # 180620
Delafield, WI 53018-9998
Phone (844) 726-3926

Other names

  • Allegiance Medical Group Doing business as

Other providers in Oconomowoc, WI

All providers in Oconomowoc, WI · Internal Medicine Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.