Provider Demographics
NPI:1821658931
Name:CORE INTEGRATED HEALTH SC
Entity Type:Organization
Organization Name:CORE INTEGRATED HEALTH SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BEYLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-224-0191
Mailing Address - Street 1:115 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-9122
Mailing Address - Country:US
Mailing Address - Phone:608-334-7700
Mailing Address - Fax:608-845-7700
Practice Address - Street 1:115 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-9122
Practice Address - Country:US
Practice Address - Phone:608-334-7700
Practice Address - Fax:608-845-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty