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Individual

DON D. AXT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
W180N8085 TOWN HALL RD, 3SW SUITE 4, MENOMONEE FALLS, WI 53051-3518
(262) 532-6899
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
396
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42929500
WI
01
P00617883
RR MEDICARE
WI
Enumeration date
06/19/2006
Last updated
08/26/2010
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