Provider Demographics
NPI:1457454381
Name:RICHARD V COLAN, MD, SC
Entity Type:Organization
Organization Name:RICHARD V COLAN, MD, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:V
Authorized Official - Last Name:COLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-258-4644
Mailing Address - Street 1:N87 W16462 JACOBSON DR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051
Mailing Address - Country:US
Mailing Address - Phone:262-255-1040
Mailing Address - Fax:262-255-4090
Practice Address - Street 1:2323 N MAYFAIR RD STE 440
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-1507
Practice Address - Country:US
Practice Address - Phone:414-258-4644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center