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Individual

DR. TRACI RENAE FRITZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6100 W STATE ST APT 404, WAUWATOSA, WI 53213-2994
(254) 485-9570
(414) 475-7706
Mailing address
6100 W STATE ST APT 404, WAUWATOSA, WI 53213-2994
(254) 485-9570
(414) 475-7706

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
64874
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1104090265
WI
05
1508830076
WI
Enumeration date
04/18/2008
Last updated
02/11/2019
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