Great Lakes Medical & Surgical Center

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

19858020 Issued in WI

Legal business name

GREAT LAKES MEDICAL & SURGICAL CENTER

Practice address

6000 South 27TH Street
Milwaukee, WI 53221

Phone

(414) 282-7575

NPI assigned

Jul 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bahram Namdari, MD

Title

Owner

Phone

(414) 282-7575

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1932308186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210464",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53221",
            "telephone_number": "414-282-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 SOUTH 27TH STREET",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53221",
            "telephone_number": "414-282-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES MEDICAL & SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "NAMDARI",
        "authorized_official_first_name": "BAHRAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-282-7575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "WI",
            "license": "19858020",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": "19858020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milan Grbic, PT
• Valena Grbic, MD
• Matthew J Grbich, D.C.
• Great Lakes Behavior Analysis, Inc.
• Great Lakes Home Health LLC
• Great Lakes Neurosurgical Associates LLC
• Greater Heights Counseling
• Greater Milwaukee Critical Care and Pulmonary Associates SC
• Greater Milwaukee Health Services, S.C.
• Greater Milwaukee Medical Services

• Surgery Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.