Individual
BRIAN DONAHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11040 N STATE ROAD 77, HAYWARD, WI 54843-3606
(715) 934-4850
Mailing address
11040 N STATE ROAD 77, HAYWARD, WI 54843-3606
(715) 934-4850
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036-098178
IL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
036-098178
IL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
72492
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-098178
—
IL
Enumeration date
05/15/2006
Last updated
06/11/2020
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