Individual
DR. EDMUND H DUTHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DIVISION OF GERIATRICS, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-6851
Mailing address
9200 W WISCONSIN AVE, DIVISION OF GERIATRICS, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-6851
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20864
WI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
20864
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000175Z
HUMANA
—
05
—
1174574123
—
WI
Enumeration date
05/15/2006
Last updated
09/11/2023
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