Individual
TAKUSHI KOHMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6900
(414) 955-6204
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6900
(414) 955-6204
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
42
WI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
51819
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013971688
—
WI
Enumeration date
04/12/2006
Last updated
03/15/2019
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