Provider Demographics
NPI:1467787622
Name:COMMUNITY CENTER FOR FAMILY HEALTH
Entity Type:Organization
Organization Name:COMMUNITY CENTER FOR FAMILY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NEVILLE
Authorized Official - Middle Name:W
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-372-7552
Mailing Address - Street 1:208 E CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-1208
Mailing Address - Country:US
Mailing Address - Phone:414-372-5553
Mailing Address - Fax:414-372-7003
Practice Address - Street 1:208 E CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-1208
Practice Address - Country:US
Practice Address - Phone:414-372-5553
Practice Address - Fax:414-372-7003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37370173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty