Individual
DJERRICK CU TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10945 N PORT WASHINGTON RD STE 201, MEQUON, WI 53092-5078
(262) 292-3151
Mailing address
10945 N PORT WASHINGTON RD STE 201, MEQUON, WI 53092-5078
(262) 292-3151
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
1025471
MA
2085R0202X
Diagnostic Radiology Physician
Primary
47802
WI
2085R0202X
Diagnostic Radiology Physician
MD20361
RI
Other
Enumeration date
11/29/2005
Last updated
02/23/2026
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