Individual
DR. MEREDITH CARTER CLUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6308 8TH AVE, STE 503, KENOSHA, WI 53143-5031
(262) 656-8213
(262) 656-8233
Mailing address
6308 8TH AVE, STE 503, KENOSHA, WI 53143-5031
(262) 656-8213
(262) 656-8233
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0021639
WI
Other
Enumeration date
07/05/2006
Last updated
12/11/2009
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