Provider Demographics
NPI:1750400735
Name:MARQUETTE UNIVERSITY
Entity type:Organization
Organization Name:MARQUETTE UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEAN
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:414-288-3812
Mailing Address - Street 1:1452 N 7TH ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53205-2301
Mailing Address - Country:US
Mailing Address - Phone:414-933-9100
Mailing Address - Fax:414-933-9200
Practice Address - Street 1:1452 N 7TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53205-2301
Practice Address - Country:US
Practice Address - Phone:414-933-9100
Practice Address - Fax:414-933-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43961000Medicaid
WI43961000Medicaid