Individual
DALE A WAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
2801 W KK RIVER PKWY, SUITE 330, MILWAUKEE, WI 53215-3669
(414) 649-3240
(414) 649-3244
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 649-3240
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
623-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42933300
—
WI
Enumeration date
03/10/2006
Last updated
11/03/2023
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