Individual
ERIC KORTBEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
10625 W NORTH AVE STE 102, WAUWATOSA, WI 53226-2315
(414) 858-2216
(414) 858-2230
Mailing address
10625 W NORTH AVE STE 102, MILWAUKEE, WI 53226-2315
(414) 877-5350
(414) 877-5360
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1364
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41931700
—
WI
Enumeration date
09/20/2006
Last updated
07/21/2022
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