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CHILDREN'S MEDICAL GROUP NPI 1205001468


NPI Information

NPI: 1205001468
Provider Name: CHILDREN'S MEDICAL GROUP

Doing Business As: MAYFAIR PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
3040 N 117TH ST
WAUWATOSA, WI
ZIP 53222
Phone: (414) 479-9990
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CHILDREN'S MEDICAL GROUP is a pediatrics in Wauwatosa, WI. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. CHILDREN'S MEDICAL GROUP NPI is 1205001468. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mayfair Pediatrics.

The provider's business location address is:

3040 N 117TH ST
WAUWATOSA, WI
ZIP 53222-128
Phone: (414) 479-9990
Fax: (414) 479-0230

The provider's authorized official is Smriti Khare .
The authorized official title is President, Children's Medical Group and has the following contact phone number (414) 266-7615.

The enumeration date for this NPI number is 4/28/2008 and was last updated on 9/24/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessionalNo
2103TC2200XPsychologistClinical Child & AdolescentNo
3104100000XSocial WorkerNo
41041C0700XSocial WorkerClinicalNo
5106H00000XMarriage & Family TherapistNo
62084P0800XPsychiatry & NeurologyPsychiatryNo
72084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryNo
8101YM0800XCounselorMental HealthNo
9208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
132844900MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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