Individual
MARY T BREGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7007 N RANGE LINE RD, GLENDALE, WI 53209-2620
(414) 352-3341
(414) 247-4588
Mailing address
4555 W SCHROEDER DR, SUITE 170, MILWAUKEE, WI 53223-1496
(414) 365-3210
(414) 365-3225
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
26922-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30800900
—
WI
Enumeration date
06/01/2012
Last updated
06/01/2012
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