Organization
MARY M. RAJALA, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARY M RAJALA M.D. (AUTHORIZED OFFICIAL)
(920) 498-4200
Entity
Organization
Contact information
Practice address
855 S MAIN ST, OCONTO FALLS, WI 54154-1241
(920) 846-3444
Mailing address
225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4257
(262) 787-4026
(262) 782-6040
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31996300
—
WI
Enumeration date
05/26/2006
Last updated
04/02/2010
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