Individual
CATHERINE MARTHA DE GRANDVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, SUITE 250, MILWAUKEE, WI 53215-3669
(414) 649-6732
Mailing address
2801 W KINNICKINNIC RIVER PKWY, SUITE 250, MILWAUKEE, WI 53215-3669
(414) 649-6732
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
52841-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100011746
—
WI
Enumeration date
11/23/2007
Last updated
01/22/2024
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