Provider Demographics
NPI:1952478299
Name:INTERNISTS LTD
Entity Type:Organization
Organization Name:INTERNISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDI
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEIDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-754-2555
Mailing Address - Street 1:PO BOX 9126
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-9126
Mailing Address - Country:US
Mailing Address - Phone:800-868-1792
Mailing Address - Fax:262-754-2552
Practice Address - Street 1:12555 W NATIONAL AVE
Practice Address - Street 2:STE 200
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151
Practice Address - Country:US
Practice Address - Phone:262-754-2555
Practice Address - Fax:262-754-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI38648207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32383100Medicaid
WI000073285Medicare PIN
WI000068343Medicare PIN
G47647Medicare UPIN