Individual
MR. RYAN WHITEHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6100
(414) 805-6147
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6100
(414) 805-6147
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
507
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083367593
—
WI
Enumeration date
02/03/2022
Last updated
09/28/2022
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