Individual
JASON TOMASELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-6588
Mailing address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-6588
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
147048
CA
207P00000X
Emergency Medicine Physician
Primary
54430
WI
390200000X
Student in an Organized Health Care Education/Training Program
125052871
IL
Other
Enumeration date
07/24/2008
Last updated
03/12/2017
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