Individual
MARK T GARNAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
9200 W WISCONSIN AVE, CARDIOTHORACIC SURGERY, MILWAUKEE, WI 53226-3522
(414) 955-6900
(414) 955-6204
Mailing address
9200 W WISCONSIN AVE, CARDIOTHORACIC SURGERY, MILWAUKEE, WI 53226-3522
(414) 955-6900
(414) 955-6204
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
40
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134116890
—
WI
05
—
42902800
—
WI
Enumeration date
09/28/2005
Last updated
01/21/2014
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