Individual
JOHN WAELTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4655 N PORT WASHINGTON RD, SUITE 100, GLENDALE, WI 53212-1004
(414) 961-7444
(414) 961-7445
Mailing address
4655 N PORT WASHINGTON RD, SUITE 100, GLENDALE, WI 53212-1004
(414) 961-7444
(414) 961-7445
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
26524
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30767800
—
WI
Enumeration date
08/21/2006
Last updated
10/31/2008
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