Individual
DR. SUSANNE M KRASOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
210 NW BARSTOW ST, WAUKESHA FAMILY PRACTICE CENTER, WAUKESHA, WI 53188-3771
(262) 548-6903
(262) 548-3820
Mailing address
210 NW BARSTOW ST, WAUKESHA FAMILY PRACTICE CENTER, WAUKESHA, WI 53188-3771
(262) 548-6903
(262) 548-3820
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47105
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029906261Q
HUMANA
—
05
—
1043261886
—
WI
Enumeration date
05/15/2006
Last updated
10/08/2013
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