Individual
AMY L DIESTELHORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-4777
(414) 805-4774
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-4777
(414) 805-4774
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
45593
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124007901
—
WI
Enumeration date
01/11/2006
Last updated
01/06/2025
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