Provider Demographics
NPI:1144214388
Name:RICHARD A STELIGA MD SC
Entity Type:Organization
Organization Name:RICHARD A STELIGA MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:STELIGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-871-8888
Mailing Address - Street 1:3070 N 51ST ST
Mailing Address - Street 2:STE 405
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1661
Mailing Address - Country:US
Mailing Address - Phone:414-871-8888
Mailing Address - Fax:414-871-9035
Practice Address - Street 1:3070 N 51ST ST
Practice Address - Street 2:STE 405
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-1661
Practice Address - Country:US
Practice Address - Phone:414-871-8888
Practice Address - Fax:414-871-9035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18634208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30262100Medicaid
B56862Medicare UPIN
01015Medicare ID - Type Unspecified