Mixter, Roger C

Mixter, Roger C is an sole proprietor health care provider with primary practice located at 5201 N Port Washington Rd , Milwaukee WI 53217-4902. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Mixter, Roger C can be contacted via phone (414) 963-0500.

Contact Information

Primary practice address
5201 N Port Washington Rd Milwaukee WI 53217-4902
Phone: (414) 963-0500
Fax: (414) 963-0359
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 26326 Wisconsin

Profile Details

NPI number 1154375996
LBN Legal business name Mixter, Roger C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 19th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154375996 NPPES
Wisconsin MEDICAID 30618600

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