Provider Demographics
NPI:1871588269
Name:MEDICAL ART RESOURCES, INC
Entity type:Organization
Organization Name:MEDICAL ART RESOURCES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAELA
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:CCA
Authorized Official - Phone:612-245-7757
Mailing Address - Street 1:3400 S 103RD ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53227-4159
Mailing Address - Country:US
Mailing Address - Phone:414-543-1002
Mailing Address - Fax:414-543-0137
Practice Address - Street 1:3400 S 103RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53227-4159
Practice Address - Country:US
Practice Address - Phone:414-543-1002
Practice Address - Fax:414-543-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersAnaplastologistGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41653200Medicaid
WI41653200Medicaid
WI41653200Medicaid