Individual
ELIZABETH ANN BUKOWY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9200 W WISCONSIN AVE, SPECIALTY CLINICS BUILDING, 4TH FLOOR, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-6851
Mailing address
9200 W WISCONSIN AVE, SPECIALTY CLINICS BUILDING, 4TH FLOOR, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-6851
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
65157
WI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
65157
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063839397
—
WI
Enumeration date
03/25/2014
Last updated
09/08/2023
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