Provider Demographics
NPI:1275978983
Name:NUMALE MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:NUMALE MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PALUBICKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-292-0450
Mailing Address - Street 1:2600 N MAYFAIR RD
Mailing Address - Street 2:SUITE 505
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1309
Mailing Address - Country:US
Mailing Address - Phone:414-727-8380
Mailing Address - Fax:414-727-8555
Practice Address - Street 1:2600 N MAYFAIR RD
Practice Address - Street 2:SUITE 505
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1309
Practice Address - Country:US
Practice Address - Phone:414-727-8380
Practice Address - Fax:414-727-8555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49753-20207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty