Basic Information
| Provider Information | |||||||||
| NPI: | 1629415591 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | APOGEE MEDICAL GROUP, WISCONSIN, S.C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2525 E CAMELBACK RD | ||||||||
| Address2: | STE 1100 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6027783600 | ||||||||
| FaxNumber: | 6023242249 | ||||||||
| Practice Location | |||||||||
| Address1: | 15059 N SCOTTSDALE ROAD | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852542685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6027783600 | ||||||||
| FaxNumber: | 6027783695 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2013 | ||||||||
| LastUpdateDate: | 10/21/2016 | ||||||||
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| AuthorizedOfficialLastName: | HARWELL | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 6027783600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 60642-20 | WI | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.