Provider Demographics
NPI:1972104156
Name:ALLIANCE ENT AND HEARING CENTER, SC
Entity Type:Organization
Organization Name:ALLIANCE ENT AND HEARING CENTER, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIEDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-727-0910
Mailing Address - Street 1:PO BOX 26071
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-0071
Mailing Address - Country:US
Mailing Address - Phone:414-727-0910
Mailing Address - Fax:414-727-0920
Practice Address - Street 1:2524 E WEBSTER PLACE
Practice Address - Street 2:SUITE 201
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4257
Practice Address - Country:US
Practice Address - Phone:414-727-0910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty