Individual
GLENA O DAVIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3289 N MAYFAIR ROAD, WAUWATOSA, WI 53222
(414) 771-7900
(414) 607-6336
Mailing address
3003 W GOOD HOPE ROAD, MILWAUKEE, WI 53209
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
32650
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31778300
—
WI
Enumeration date
07/18/2006
Last updated
01/25/2011
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