Individual
SEAN CARROLL TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N MAYFAIR RD, SUITE 500, WAUWATOSA, WI 53226-1409
(414) 257-2525
(414) 257-1772
Mailing address
2500 N MAYFAIR RD, SUITE 500, WAUWATOSA, WI 53226-1409
(414) 257-2525
(414) 257-1772
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
45930-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34989800
—
WI
Enumeration date
10/06/2006
Last updated
09/22/2008
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