Individual
DR. M THOMAS CHEMOTTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
N54W6135 MILL ST, CEDARBURG, WI 53012-2021
(262) 377-8118
Mailing address
PO BOX 503, CEDARBURG, WI 53012-0503
(262) 377-8118
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
21631
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21631
STATE MD LICENSE
WI
Enumeration date
03/14/2006
Last updated
11/13/2009
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