Individual
LUZ STELLA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
637 W MITCHELL ST, MILWAUKEE, WI 53204-3513
(414) 383-8989
Mailing address
637 W MITCHELL ST, MILWAUKEE, WI 53204-3513
(414) 383-8989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28128
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30846600
—
WI
Enumeration date
03/31/2006
Last updated
05/30/2008
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