Provider Demographics
NPI:1548252547
Name:FRITSCHE, CLAIRE M (MD)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:M
Last Name:FRITSCHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:M
Other - Last Name:MONTANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:335 MAHN COURT
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154
Mailing Address - Country:US
Mailing Address - Phone:414-762-2020
Mailing Address - Fax:414-762-2024
Practice Address - Street 1:3120 SOUTH 27TH STREET
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215
Practice Address - Country:US
Practice Address - Phone:414-672-8282
Practice Address - Fax:414-672-8284
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22468207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30656900Medicaid
WI30656900Medicaid
02217005Medicare ID - Type Unspecified
A57791Medicare UPIN