Individual
DR. DAVID MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8466
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8466
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
TRN18887
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
66680-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114364528
—
WI
Enumeration date
05/24/2013
Last updated
05/30/2019
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