Individual
BRENDA L. BOSCHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1185 CORPORATE CENTER DRIVE, PROHEALTH CARE MEDICAL ASSOCIATES, INC., OCONOMOWOC, WI 53066-4887
(262) 928-8400
(262) 928-8484
Mailing address
N17 W24100 RIVERWOOD DR, PROHEALTH CARE MEDICAL ASSOCIATES, INC., WAUKESHA, WI 53188
(262) 928-4100
(262) 928-5835
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
41423
WI
208000000X
Pediatrics Physician
41423
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34257100
—
WI
Enumeration date
02/06/2006
Last updated
11/02/2011
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