Individual
STEPHANIE M MAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1777 W GRAND AVE, PORT WASHINGTON, WI 53074-2077
(262) 284-3456
Mailing address
1777 W GRAND AVE, PORT WASHINGTON, WI 53074-2077
(262) 284-3456
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
49574
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34717600
—
WI
Enumeration date
08/29/2006
Last updated
08/07/2025
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