Provider Demographics
NPI:1770707358
Name:BEJMA, JEFFREY PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:PAUL
Last Name:BEJMA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:W129N7055 NORTHFIELD DR
Mailing Address - Street 2:COMMUNITY MEMORIAL MEDICAL COMMONS
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-0538
Mailing Address - Country:US
Mailing Address - Phone:262-253-5400
Mailing Address - Fax:262-253-3399
Practice Address - Street 1:W129N7055 NORTHFIELD DR
Practice Address - Street 2:COMMUNITY MEMORIAL MEDICAL COMMONS
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-0538
Practice Address - Country:US
Practice Address - Phone:262-253-5400
Practice Address - Fax:262-253-3399
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2013-01-29
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Provider Licenses
StateLicense IDTaxonomies
LA026270208800000X
WI56116208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1770707358Medicaid
WI68086 1058Medicare PIN
WI73601 2242Medicare PIN
LA1052574Medicare ID - Type Unspecified