Provider Demographics
NPI:1598761983
Name:MCGRATH, PATRICK JOSEPH (DO)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOSEPH
Last Name:MCGRATH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1801 DOLPHIN DR
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-1430
Mailing Address - Country:US
Mailing Address - Phone:414-231-4000
Mailing Address - Fax:262-446-0388
Practice Address - Street 1:1825 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-1933
Practice Address - Country:US
Practice Address - Phone:414-274-8407
Practice Address - Fax:414-298-8616
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI24991207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30021500Medicaid
WIAM1664817OtherDEA
WIAM1664817OtherDEA