Individual
DR. JAIME DIAZ CABATINGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2061 CHEYENNE CT, GRAFTON, WI 53024-9368
(262) 376-1934
(262) 375-2076
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(262) 376-1934
(262) 375-2047
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19401
WI
Other
Enumeration date
01/11/2008
Last updated
12/03/2012
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